#the Children Born through Assisted Reproductive Technologies Protection Act

[coochiequeens]

If 100 couples seek surrogacy services in Thailand, they will likely spend 100 million baht here.” - Dr. Sura Wisedsak

Well if commercial surrogacy can pump money into the nations economy who gives a fuck about women and the babies that would be born through this? Apparently not Doctor Wisedsak.

The idea of legalizing surrogacy services for foreign couples, including LGBTQ partners, promises rich benefits for Thailand’s medical industry – but has also triggered grave concerns about human trafficking risks.

“I am not against attracting the flow of foreign currency. But I would urge caution and also demand assurances that it [surrogacy for foreigners] will not leave Thailand labeled as a human-trafficking country,” said Prof. Dr. Kamthorn Pruksananonda, a lecturer in Obstetrics & Gynecology at Chulalongkorn University’s Faculty of Medicine.

Prof. Dr. Kamthorn Pruksananonda

The medical lecturer pointed out that the concern about the sale and exploitation of children born from surrogacy arrangements were so prominent that they often feature in reports to the United Nations General Assembly.

“Such arrangements may be connected to child pornography,” he said, highlighting one aspect of the dangers associated with surrogacy.

Kamthorn said Thai authorities teamed up with United States’ Homeland Security Investigations to crack down on an illegal multinational surrogacy gang in Thailand several months ago. Foreign security agencies see Thailand as a base for human traffickers exploiting surrogacy services, he added.

“Lax legal enforcement means illegal surrogacy services are still able to operate here,” he said.

Efforts to protect kids

In 2015, Thailand passed a law to protect children born through assisted reproductive technologies, to prevent foreigners from hiring Thai women to serve as surrogate mothers. Prior to the law’s enactment, such surrogacy services were widely available in Thailand.

“We drafted the Children Born through Assisted Reproductive Technologies Protection Act to plug legal loopholes. With so many foreigners coming to Thailand for surrogacy services, there was a risk of human trafficking,” Kamthorn said.

The medical expert sits on the committee for the protection of children born through assisted reproductive services, and also the Royal College of Obstetricians and Gynecologists’ committee on Reproductive Endocrinology and Infertility.

During the passage of the new law, a scandal erupted over a Thai surrogate mother who was left struggling with the burden of raising a Down Syndrome baby – named Gammy – after the infant was abandoned by his biological Australian parents. The foreign couple left Thailand with only Gammy’s twin sister after medical tests confirmed she was healthy and did not have Downs.

The scandal deepened after an investigation revealed that the Australian father had been convicted twice of molesting girls. This new finding also raised questions about the ethics of gestational surrogacy.

Under Thailand’s current law, only Thai heterosexual couples married for more than three years can hire a surrogate to have their child. Commercial surrogacy serving foreign clients and LGBTQs is currently banned.

Penalties for illegal surrogacy under the new law are severe.

A surrogate mother faces up to 10 years in jail and a maximum fine of 200,000 baht if she joins an illegal surrogacy service. Those caught selling sperm or eggs are punishable by up to three years in jail and/or a fine of 60,000 baht. And an agent for illegal surrogacy services faces five years in jail and/or a fine of 100,00 baht.

Proposed changes

According to Dr. Sura Wisedsak, director-general of the Department of Health Service Support (DHSS), the scope of the law is set to be expanded so that Thai surrogacy services also cover foreign and LGBTQ couples.

Dr. Sura Wisedsak

He pointed to the financial benefits of this move.

“If 100 couples seek surrogacy services in Thailand, they will likely spend 100 million baht here.”

Sura said Thai services and expertise in surrogacy are second to none, so would attract plenty of foreigners.

“Our service fees are also cheaper,” he added.

Thailand currently has 115 providers of services related to infertility. Of these, 17 are state hospitals, 31 are private hospitals and 67 are private clinics.

Each year, they provide around 12,000 artificial insemination procedures and around 20,000 in vitro fertilization services. These form part of a growing surrogacy sector serving couples who are unable to conceive naturally. Authorities have so far approved 754 surrogacy applications – accounting for 97.2% of total requests. The success rate of these services is currently 48.53% – up from 46%.

Dr. Olarik Musigavong, a reproductive medicine specialist, is an enthusiastic supporter of legalizing surrogacy services for foreigners, explaining that it will generate income for Thailand and enrich the skills of Thais working in the field.

“The government could also use tax revenue from the expanded surrogacy sector to subsidize assisted reproduction for Thais who need but cannot afford such services,” he said.

Asked about the potential dangers of commercial surrogacy, Olarik said that if proper control measures were in place, human trafficking would not be a risk.

“If we legalize the services, illegal practices will fade. And with a legal process and clear registration, those involved won’t be able to abandon kids either,” he said.

In some countries, the commercial system is so well-established that there are even sperm/egg banks that pay donors, Olarik said.

DHSS deputy director-general Arkom Praditsuwan said to prevent human trafficking, couples seeking surrogacy services may be asked to prove their good financial status.

Dr. Olarik Musigavong

‘Illegal practices put surrogate moms at risk’

Kamthorn said numerous Thai women who volunteered to serve as surrogate mothers for underground operations have ended up receiving substandard care. They have been crowded together in condo apartments and sometimes medicated to produce more eggs than they should.

“A few months ago, a teenager ended up in an intensive care unit due to the practice of overdosing with medication. She nearly died,” he said, “Agents don’t give a damn. They just try to lower costs to maximize their profits.”

Thai advertisements looking for surrogate moms are easily found on the internet.

They typically offer 500,000 baht plus monthly allowances during the surrogacy period. The monthly pay usually ranges between 10,000 and 20,000 baht.

Underground surrogacy rings usually divide their operations into several parts, each handled by different units, making it difficult for authorities to investigate and prosecute.

The Department of Special Investigation says a recent case involved Chinese customers hiring an underground ring operating in Thailand and neighboring countries.

In Thailand, they used three clinics for prenatal care and child-delivery services. Investigators found the gang had well over 100 million baht in cash flow at the time they were arrested.

By Thai PBS World’s General Desk

[nurturingfather44]

The Potential of Surrogacy in South Africa

In recent years, surrogacy in South Africa has emerged as a viable option for couples struggling with infertility or unable to conceive due to medical reasons. This method offers hope and a pathway to parenthood for those facing such challenges. With advancements in medical technology and a growing acceptance of alternative reproductive methods, surrogacy has become a lifeline for many hopeful parents.

Understanding Surrogacy

Surrogacy is a reproductive arrangement where a woman, known as a surrogate, carries a child for the intended parents. This process involves various legal, medical, and emotional considerations. In South Africa, surrogacy is regulated by specific laws to ensure the rights and protection of all parties involved.

The Role of a Surrogate in South Africa

A surrogate in South Africa plays a crucial role in helping individuals or couples achieve their dream of having a child. These compassionate women selflessly offer their bodies and time to carry a child for others, providing a priceless gift of parenthood. The decision to become a surrogate is deeply personal, driven by a desire to make a difference in someone else's life.

Navigating Through a Surrogate Agency

A surrogate agency acts as an intermediary between intended parents and potential surrogates, facilitating the entire surrogacy process. These agencies provide invaluable support, guiding both parties through legalities, medical procedures, and emotional aspects of the journey. They play a pivotal role in matching intended parents with suitable surrogates, ensuring compatibility and mutual understanding.

Legal Framework for Surrogacy

South Africa has specific laws governing surrogacy, outlined in the Children's Act. These regulations aim to safeguard the rights of all parties involved, including the child born through surrogacy. Legal contracts are drafted to establish the rights and obligations of intended parents and surrogates, offering clarity and protection throughout the process.

Medical Advancements

Advancements in medical technology have revolutionized the field of surrogacy, making the process safer and more accessible. Fertility clinics equipped with state-of-the-art facilities offer comprehensive medical support to intended parents and surrogates. From initial consultations to embryo transfer and prenatal care, these clinics ensure a seamless and successful surrogacy journey.

Emotional Support and Counseling

Embarking on a surrogacy journey can be emotionally taxing for all parties involved. Therefore, emotional support and counseling services are integral components of the process. Experienced professionals provide guidance and assistance to intended parents and surrogates, helping them navigate through the highs and lows of the journey with empathy and understanding.

Surrogacy in South Africa represents a beacon of hope for individuals or couples facing fertility challenges. With the support of dedicated professionals, legal frameworks, and medical advancements, the surrogacy journey becomes a feasible option for achieving the dream of parenthood. By embracing surrogacy, South Africa offers a ray of hope to those longing to experience the joy of having a child.

[inder244-blog]

Procedure of surrogacy

Procedure of surrogacy

These days surrogacy is prevalent globally, so why should India lag behind in such a situation? Surrogacy has also gained fame in India. From big Bollywood actors, businessmen and ordinary people are adopting this method.

The cost of taking surrogacy in India or fertility treatment is many times less than other countries and there are many women available in India who are ready to become surrogate mother easily. From getting pregnant to delivery, the women are well looked after as well as they are given a significant amount.  

What is surrogacy

process of surrogacy starts with agreement between a woman and a couple who wants their own child. In general terms, surrogacy means a woman’s ‘surrogate womb’ until the birth of a child. Understand  Who needs surrogacy and how to get egg donor.

The help of surrogacy is usually taken when a couple is having difficulty in giving birth to a child. Repeated miscarriages or repeated IVF techniques are failing. The woman who is ready to give birth to another couple’s child from her womb is called ‘surrogate mother’. ( arrange a surrogate mother )

Dynasty traditions and surrogacy in India

In recent times, surrogacy has become a more preferred option for single parents. This is being given priority as genetic genealogy is still important in our country as matters of inheritance are important for the Indian family system, there is still a lineage tradition in India. So with the development of medical science, surrogacy came as a boon for couples whose medical condition did not support them biologically for the child. In such cases, another woman child is taken to parents under a legal contract. After the child is born, the surrogate mother has no relationship with the child. Parents whose ova and sperm are used to perform this procedure are considered the legal parents of the child.

 India “Fertility Tourism”

Surrogacy is known as the concept of ‘renting the womb’. Since 2002, commercial surrogacy in India has been legalized as per the guidelines by the Indian Council of Medical Research (ICMR). With the scope of earning money from carrying a child, the number of potential surrogates in India is quite high. International demand in the region has promoted the region as a niche market so that India becomes famous as a place for ‘fertility tourism’ or ‘baby factories’.

Gujarat is known as the ‘Surrogacy Capital’ of India, where the city of Anand is famous worldwide for surrogacy. Although surrogate mothers receive adequate medical, nutritional and health care through surrogacy agreements, cases of abuse, abandonment, and exploitation have forced the government and courts to look into the state of affairs. As of now, there is no official law in India regarding surrogacy.

Guidelines are normalized by ICMR and provide protection such as:

Prohibition of gender selector surrogacy.

Surrogacy should not be biologically linked to the child

Birth certificate to keep the names of commissioning parents only.

At least one parent must be a commission payer.

Surrogacy’s life insurance coverage must be paid by the commissioning parent.

Right to privacy of mother and donor.

Surrogacy

In the case of Baby Manji Yamada vs. Union of India (2008), in which a Japanese couple turned on surrogacy and they divorced and then the mother refused to accept the child and the father as a male Child custody was refused. The Japanese government allowed the adoption of the child by paternal grandmother due to a genetic connection on humanitarian grounds. However, the Supreme Court has admitted that being a single male parent can take the responsibility of a child and a recent example of which is Bollywood director Karan Johar. Karan has become a father only through surrogacy and is responsible for both his children. Play well

Citizenship issues arose in cases involving German parents, as a child born with surrogacy officially receives parental citizenship. Countries such as France, Germany, Italy, Spain, Portugal and Bulgaria prohibit all forms of surrogacy. In this case dual citizenship is not allowed in India due to legal complications. The German couple had to go through the process of adopting twins according to German laws two years after their birth.

Surrogacy bill

In 2008, the Assisted Reproductive Technology (ART) (Regulation) Bill was drafted, but even after two amendments in 2010 and 2014, it could not be passed by Parliament.

The Surrogacy (Regulation) Bill 2016, which is currently pending in Parliament, aims to protect the rights of surrogate mothers and make the system of surrogacy in India more transparent. If the bill is passed, the Act will lay down strict laws related to surrogacy.

Highlights of Surrogacy Regulation Bill ( Get to know surrogacy procedure )

1. Only Indians in the country will be able to take surrogacy facility

2. Only legally valid couple will get benefit

3. Unmarried, gay, live in, single parents are not allowed

4. Only after five years of marriage, the couple will be able to help surrogacy

5. If you already have a child, you will not be able to take surrogacy facility

6. Possible 10 years imprisonment for violators of law

For more information, call at :  +91 – 8929020600

     Visit Website  –www.elawoman.com

[duaneodavila]

Parental Rights In New York To Graduate From The Dark Ages, Hopefully

(Image via Getty)

Many New York parents are currently in a very scary legal environment, and they may not even know it. Did you know that a hopeful single parent who turns to a known sperm donor to conceive in New York has no way to sever the donor’s parental rights? That’s right. And that means that a sperm donor can, at any time, seek parental rights to the child. Vice versa, the parent can seek child support from the sperm donor. That’s concerning! The situation is also true for egg and embryo donations.

New York attorney and adoption and assisted reproductive technology powerhouse, Denise Seidelman, spoke to me about the current problematic legal environment, as well as her ongoing efforts to fix the situation, and to protect parents and children. Seidelman and her law partner, Nina Rumbold, are among those in New York zealously advocating for the passage of the Child-Parent Security Act (CPSA).

Even The Governor Wants It!

The CPSA was introduced in 2013 by Assemblymember Amy Paulin and State Senator Brad Hoylman. Hoylman is himself a parent of two children born through surrogacy. Hoylman and his husband were forced to go outside of New York to have their children through surrogacy because, in addition to the bleak donor situation, compensated surrogacy is illegal in New York.

The CPSA has undergone a number of revisions since its initial proposal, and is still undergoing a few finishing touches. But not until this year did anyone have as much hope that this legislation could pass. Key among factors giving New Yorkers newfound optimism is the vocal support of New York Governor Andrew Cuomo. The Governor has publicly supported the bill, explaining that “New York’s antiquated laws frankly are discriminatory against all couples struggling with fertility, same sex or otherwise.” Even more exciting, the Governor initially included the CPSA in his executive budget plan. However, it was removed in the last few weeks — possibly out of an interest in letting the legislature pass the bill with the latest updates.

What’s So Special About This Bill?

It protects children, for one! No kid should be stuck in the middle of a legal battle questioning who his or her legal parent is, merely because New York’s laws are decades out of date. Specific protections for families and those who help them include:

Clarifying and protecting parental rights when a sperm donor, egg donor, or embryo donor assists with conception. About time! Seidelman explained that while the surrogacy aspects of the bill are getting most of the attention, she is especially excited about the positive impact of the donor-related provisions. The bill provides that those who turn to a donor can be assured that they are the legal parents of their child, and that a donor can’t claim parental rights to the child. And, on the other side, that donors can rest easy that their good deed of helping another family no longer opens them to the risk of later being sued for child support for the child. This protection could encourage more couples to donate remaining embryos to others to form their families, rather than destroying them or donating them to research.

Legalizing compensated gestational surrogacy. At the moment, New York is among a small minority of U.S. states which dictate that a woman is not permitted to receive compensation if she chooses to act as a gestational surrogate for another. In fact, it’s criminal.

For those who fear the exploitation of women and commodification of children (the arguments made by opponents to legalization), the bill includes a number of protective measures for the sake of all participants. These include, among others, provisions requiring:

Ø  Independent legal counsel for all parties.

Ø  Access to mental health services throughout the pregnancy for the woman acting as a gestational carrier, at the cost of the intended parents.

Ø  Major medical insurance in place for the gestational carrier and disclosure of how medical costs will be covered.

Ø  Ability to terminate the arrangement any time prior to the transfer without penalty.

Ø  Clear autonomous rights of the gestational carrier, including in situations involving complications of the pregnancy where termination may be considered.

Ø  Clear delineation of parental rights, including the requirement that intended parents take their child no matter the baby’s condition (no Baby Gammy cases!).

Wise Changes

The changes, if they go through, will significantly improve the state of New York law, and protect parents and donors. They would also bring New York into the 21st century. Look, New York, no one is asking you to be California. But do you really want to fall behind New Jersey?! (They reversed their ban on gestational surrogacy last year.) Maybe that’s enough by itself to make these positive changes happen.

Ellen Trachman is the Managing Attorney of Trachman Law Center, LLC, a Denver-based law firm specializing in assisted reproductive technology law, and co-host of the podcast I Want To Put A Baby In You. You can reach her at babies@abovethelaw.com.

Parental Rights In New York To Graduate From The Dark Ages, Hopefully republished via Above the Law

[marymosley]

Analysis: Surrogacy Procedures in India and the Laws

A country like India with a suspiciously declining fertility rate of around 2.2 (births per woman) witnessed a rise in infertile couples opting surrogacy as an alternative reproductive choice in the last decade. Globally, 15 % of reproductive-aged couples are affected by infertility.[1] There are a number of factors that lead to infertility including, but not limited to- obesity, diabetes, mental stress, sexually transmitted infections, overuse of emergency contraceptives, hormonal imbalance, etc.[2] With a rapid boost in urbanisation and technology, these issues have jumped into the spotlight. Yet, surrogacy stays an under-developed field in the Indian legal context.

 The debate and discussion on surrogacy is as old as surrogacy itself. It has been quite a controversial issue owing to its complex nature and the abject lack of a just and firm legislation to regulate it. As and when posed with a legal complication and a dire need for a legislation, the Legislature and the judiciary have made attempts to atone and introduce a framework for surrogacy clinics to operate. We shall discuss this later into the paper. However, none of these efforts have reached fruition as of yet and the ambiguity around the subject remains intact.

Owing to all this, the vulnerability of a surrogate mother is the highest among the parties to a surrogate arrangement. There have been instances where the delivered baby was refused acceptance by intended parents due to divorce or some abnormality in the child. A landmark case that describes this scenario perfectly is the Baby Manji Yamada vs. UOI and Anr.[3] (2008) along with a few other cases which will later be discussed in this paper. Before delving into the rights and obligations related to surrogacy, let’s briefly understand what surrogacy is.

 What is Surrogacy?

In a nutshell, surrogacy is a system of assisted reproduction wherein the intended parents rely on a surrogate mother who is willing to carry and care for their baby until birth. Intended parents that are unable to conceive naturally use surrogacy to start or grow their families while maintaining their heredity. This could be because of infertility or some physical abnormalities/conditions of the biological mother that make it unsafe for her to carry the child. There are variations in surrogacy on the basis of Genetic relationship (Gestational vs. Traditional), Payment of the surrogate (Compensated vs. Altruistic), place of completion (Domestic vs. International), etc.

          Gestational Surrogacy vs. Traditional Surrogacy-

In gestational surrogacy, the child is not biologically related to the surrogate mother (gestational carrier). Instead, the embryo is created via in vitro fertilization (IVF), using the eggs and sperm of the intended parents or donors, and is then transferred to the surrogate. In contrast to this, in Traditional Surrogacy, the surrogate mother is artificially inseminated with the intended father’s or a donor’s sperm. Since the surrogate contributes her own egg and thus has a biological link with the baby, it is also called as ‘partial surrogacy’.[4]  

Compensated vs. Altruistic Surrogacy

When intended parents pay a surrogate mother compensation above and beyond reimbursement of her medical expenses for carrying their baby till birth, it is called compensated or commercial surrogacy. Altruistic Surrogacy, on the other hand, is when the surrogate mother gets no additional monetary compensation apart from for maintenance and other pregnancy related expenses. Most of these arrangements happen between close friends or relatives of the intended parents.

Surrogacy has proven to be a sigh of relief for infertile couples who go through the trauma of being unable to reproduce naturally. Regardless, it still isn’t a cake-walk and has psychological as well as social barriers that makes opting for surrogacy a tough call. Besides, commercial surrogacy, by the Surrogacy (Regulation) Bill, 2019 (passed by Lok Sabha), is on its way to be completely banned in India owing to a multitude of illegal rackets, unregulated procedures, legal complications and above all, the outright exploitation of the surrogate mother. The ban was partially imposed by ICMR on 28th September, 2015 by sending a letter notifying all clinics in India to disallow foreign commissioning parents to have babies through an Indian surrogate mother. Most states do not allow traditional surrogacy and delimit surrogacy agreements to altruistic and gestational forms. For eg., UK, Denmark, Australia, Canada and Greece permit only altruistic surrogacy while Germany, France, Italy and Sweden have a blanket ban on surrogacy.[5] India, on the other hand is still in the grey when it comes to a definite surrogacy regulations.

Brief History of Surrogacy in India.

On 3rd October, 1978, the successful birth of the first IVF baby Kanupriya alias Durga in Kolkata sowed the seed of surrogacy as an alternative reproductive technology (ART) in India. In the year 2002, commercial surrogacy was made legal in India. The technology developed and mushroomed in a way, that by 2012, India came to be known as the ‘Surrogacy Capital of the World’ having approximately a $500 million per annum market.[6] Couples from all over the world seeking surrogates at cheaper rates started flying to India. However, along with prosperity, came a plethora of legal and philosophical complications. Being an awfully unregulated sector, unsafe and unethical practices sprouted to meet the foreign demand.

Baby Manji Yamada v. Union of India[7], a landmark case that made the apex court question the validity of commercial surrogacy set into motion talks for having the country a just and solid legislation. In the said case, the biological parents, Dr. Yuki Yamada and Dr. Ikufumi Yamada came to India in 2017 and entered in an agreement with a surrogate mother in Anand, Gujarat. Subsequently, the surrogate baby was born on 25/6/2008. By this time, the intended parents, due to marital conflicts had separated and though it was agreed upon initially that the father would be granted custody if such a situation arose, Dr. Yuki’s visa expired and he had to fly back to Japan. Nonetheless, he tried to still claim the baby by applying for her passport, but the Japanese Civil Code[8] bore no recognition for surrogate children born to a woman of non-Japanese origin and thus, rejected his application.

At this point, the baby didn’t belong to anyone. Even the surrogate mother was absolved of rights and responsibilities with the delivery of the baby. Between this labyrinth of legal and diplomatic complications, Manji’s paternal grandmother, Emiko Yamada flew to India to foster the baby.  Soon, a Jaipur based NGO- SATYA moved Rajasthan High Court using the writ of Habeus Corpus claiming illegal custody of Manji by Emiko. The case advanced and the Court gave a four weeks notice to produce the baby before it. Seeking justice for herself and the baby, a helpless Emiko moved the apex court for intervention.[9] The court, inter alia, gave the government directions with respect to the grandmother’s visa extension and the baby’s passport grant. Later, The Regional Passport Office, Rajasthan issued a first of its kind Certificate of Identification which didn’t have a mention of nationality and mother’s name for the baby to expedite her transit to Japan. Ending the story on a happy note, Japanese Embassy granted the child a one-year visa on humanitarian grounds and Baby Manji and Grandma Emiko flew back to Japan.

This case, however influential, failed to address the outburst of commercial surrogacy and its ill-reaching impacts on poor women. On the other hand, it is laudatory that the court rendered its decision in time considering the predicament of the baby. Nonetheless, it put forth the dire need for a well-structured and inclusive legislation for surrogacy arrangements.

Another case similar to this is that of Jan Balaz v. Anand municipality and ors.[10] in which a German couple that followed the same process of trying to have a baby inexpensively through an Indian surrogate faced parental ownership issues. In this case, twin babies, Leonard and Nicolas were, by the order of the Gujarat High Court issued two overseas Indian passports. Since the babies were born in India, they were already established to be citizens of India by the S (3)(1)(c)(ii) of the Citizenship Act, 1955. The babies were allowed to return home after the parents successfully adopted them. They, nonetheless, remained citizens of India.

To counter these practices, the ICMR (Indian Council for Medical Research), in 2005, came up with a set of provisional guidelines- The National Guidelines for Accreditation, Supervision and Regulation of ART Clinics in India, which in furtherance, became the Assisted Reproductive Technologies (Regulation) Bill 2008 followed by a revised draft in 2010 and 2013. After much deliberation and research, In February this year, the Assisted Reproductive Technology (Regulation) Bill, 2020 was approved by the cabinet.

The 228th Law Commission report took suo motu cognizance of the issue at hand. It was titled, ‘Need for legislation to regulate Assisted Reproductive Technology clinics as well as rights and obligations of parties to a surrogacy’. It was chaired by Dr. Justice A.R. Lakshmanan. A few suggestions by the commission were[11]-

Surrogacy arrangements should be governed by contract between the parties, but such arrangements shouldn’t be for commercial purposes.

Birth certificate of the surrogate child should contain name(s) of the commissioning parent(s) only.

Right to Privacy of donor as well as surrogate mother should be protected.

Sex-selective surrogacy should be prohibited.

Cases of abortion should be governed by Medical Termination of Pregnancy Act, 1971.

          All of these efforts contributed substantially to form the draft of Assisted Reproductive Technology (Regulation) Bill, 2014. Apart from this Bill, in November, 2016, the Surrogacy (Regulation) Bill, 2016 was introduced in and passed by the Lok Sabha. It sought to confine surrogacy to non-commercial, altruistic and performed by a ‘close relative’. The bill was drafted in a way that it reflects the “ethos of the Indian people”.[12] However, this bill was further referred to a Parliamentary Standing committee (PSC) which suggested some pivotal changes like expanding the scope of being potential surrogate mothers to any willing woman and not just close relatives, raising the insurance cover, allowing compensated surrogacy, including live-in couples, NRIs, widows, divorced women, etc.[13] Ignoring most of these suggestions, a bill similar to the 2016 bill, the Surrogacy (Regulation) Bill, 2019 was passed by the Lok Sabha in August 2019. The Rajya Sabha considered it fit to refer the bill to a Select committee before passing it. After flood, storm and fire, today, we have The Surrogacy (Regulation) Bill, 2020 (introduced before the Parliament)[14] and the Assisted Reproductive Technology (Regulation) Bill, 2020 (Pending before Lok Sabha)[15]  that have the potential to legally transform the landscape of surrogacy in India. Let’s roll into analysing these bills vis-à-vis rights and obligations of parties to surrogacy arrangements.

Rights and Obligations of Parties to Surrogacy arrangements.

          The parties to Surrogacy ‘contract’ are the surrogate woman, her husband if she is married, the surrogate child and the intending parent(s).[16] A Surrogacy Agency and the donor may or may not be a party to the ‘arrangement’ depending on whether the intending couples choose to opt for one or not. In light of the drafts of the Surrogacy (Regulation) Bill and Assisted Reproductive Technology (Regulation) Bill, following are the rights and obligations of these parties-

The intended parents need to produce-

A certificate of proven infertility (of either or both) obtained from a district medical board in order to enter into a surrogacy contract. In the 2019 Surrogacy Regulation Bill, ‘infertility was defined as “the inability to conceive after five years of unprotected coitus or other proven medical condition preventing a couple from conception”. However, the 2020 bill seeks to delete this definition, since 5 years was too long a period to wait for a child.

An order concerning the parentage and custody of the child to be born through surrogacy passed by a court of the Magistrate of the first class or above, on an application made by the intending couple and surrogate mother.

An insurance coverage of such amount as may be prescribed[17] in favour of the surrogate mother from an insurance company or an agent recognised by the Insurance Regulatory and Development Authority established under the Insurance Regulatory and Development Authority Act, 1999.

An eligibility certificate issued by appropriate authority after ensuring the intending couple – is aged between 23-50 years in case of the female and 26-55 years in case of the male; is married for at least 5 years and are Indian citizens or Overseas Citizen of India (OCIs), People of Indian Origin (PIOs), Non Resident Indians (NRIs) and foreigner married to an Indian citizen; have not had any surviving child biologically or through adoption. Note that the last condition doesn’t apply if the intending couple have a child who is mentally or physically challenged or suffers from life threatening disorder or fatal illness with no permanent cure.

It is the obligation of the surrogacy clinic to explain thoroughly all known side effects and after effects of the procedure to the surrogate mother and get a written consent from her in the language she understands.

The commissioning couple is obliged to not abandon the child, born out of a surrogacy procedure, whether within India or outside, for any reason whatsoever, including but not restricted to, any genetic defect, birth defect, any other medical condition, the defects developing subsequently, sex of the child or conception of more than one baby, etc. They also aren’t allowed to avail services of more than one surrogate at a time.

A surrogacy clinic has to compulsorily register itself by making an application to an appropriate authority under the act. It can operate only after authorisation by the authority.

Neither of the parties to the surrogacy agreement can conduct, offer, undertake, promote or associate with or avail of ‘commercial surrogacy’ in any form; exploit or cause harm to the surrogate mother or child in any manner whatsoever; advertise or promote commercial surrogacy in any manner.

No person, organisation, surrogacy clinic, laboratory or clinical establishment of any kind shall force the surrogate mother to abort at any stage of surrogacy except in such conditions as may be prescribed.

The intended parents are bound by the surrogacy agreement to pay for the surrogate’s expenses that include expenses related to the entire medical procedure of surrogacy, expenses of feeding the embryo in the gestation period, the attorney’s fee (if appointed) and all other medical expenses as and when required.[18]

The surrogate is also obligated to nurture the child in her womb during the gestational period (this includes feeding herself well, regular visits to gynaecologists, proper medication, etc.) The surrogate is duty-bound not to engage in any act that may harm the foetus in any manner. At the same time, the surrogate and her husband are not allowed to have an extra-marital affair during the gestation period. The Surrogate has to hand over the baby, relinquishing all her parental rights, to the intended parents at the time decided in the agreement which may be right after delivery or after the breastfeeding period.[19]

Surrogate mother should be an ever married Indian woman between 25-35 years of age and shall have at least one live child of her own with minimum age of three years and should act as a surrogate for not more than one successful live birth in her life and with not less than two years interval between the two deliveries.

If the first embryo transfer fails, the surrogate shall undergo not more than two more embryo transfers for the same couple.

The child born through a surrogacy shall have-

The status of legitimate child of the commissioning couple (even if the married couple divorce).

Identical legal rights as a legitimate child born out of sexual intercourse.

Overseas Citizenship of India under Section 7A of Citizenship Act, 1955 if born to Overseas Citizen of India, People of Indian Origin or a foreigner married to an Indian citizen.

The right to ask for information, excluding personal identification, regarding the donor or the surrogate.

 [extracted from the Surrogacy (Regulation) Bill, 2019 and the Assisted Reproductive Technology (Regulation) Bill, 2017]

     All these rights and obligations of parties along with other provisions negotiated between the parties need to be drafted into a surrogacy contract which shall be legally enforceable.

State of the Indian Surrogate- the past, the present, the future.

          The Surrogacy (Regulation) Bill, 2016 defines a surrogate mother as “a woman bearing a child who is genetically related to the intending couple, through surrogacy from the implantation of embryo in her womb..”. Surrogacy is more than just an alternative way of conceiving babies. It involves sacrifices made by a woman out of her own free will to bless an unfortunate couple with a child and complete a family. In India, specifically, where surrogacy is limited to only altruistic means, a woman coming forward, ignoring social stigma to take up the enormous responsibility of fostering a child not belonging to her in her womb and then handing it over on delivery is worth a ton of praise.

          For years, in India, commercial surrogacy was practised freely without any regulation. This boosted the sector by leaps and bounds. India saw an exponential influx of foreign demands for surrogacy and to cater to it, an unregulated, uncontrolled practice of ‘renting wombs’ took seed and it put the surrogate mother in a highly vulnerable position. Diksha Munjal-Shankar conducted an empirical study[20] in 2014 at a renowned infertility clinic in Anand, Gujarat and it showed some findings that depicted the unfortunate status of surrogates then. It was found that most of the surrogates had received only basic education, belonged to poor households and didn’t have a monthly salary of more than Rs. 3000/month. They were drawn towards commercial surrogate motherhood only by the prospect of earning 10 times their normal monthly income since they received upto Rs. 3,75,000 from the surrogacy arrangement. However, the state in which the surrogate mothers were kept was way below adequate. They were kept in hostel rooms having single iron beds with 2.5-3 feet of distance between each. The food provided to them was below par and most of them complained about it. They weren’t allowed to leave the facility even for a simple stroll. This clearly violated their freedom of movement guaranteed under Art. 19 of the Constitution of India. Even if they felt like stepping out, the fear of social censure haunted them. Besides, the surrogates usually didn’t meet the commissioning couples during the gestational period. They had minuscule amount of mental and emotional support. The worst of all this was that the surrogates weren’t thoroughly adept with the surrogacy procedure and the agreement between the parties too, was in English. This put them in an ever more vulnerable position in the bigger scheme of things. After the delivery, the baby was immediately handed over to the commissioning parents and for the purpose of feeding the child, apparatuses were used to pump out the mother’s milk. These are still findings from just one study conducted in one clinic.

          There have also been instances of sex-selective abortions and post-delivery abandonment of the child due to some birth defect. All these findings point to the commodification of the surrogate mother and the surrogate child. Nonetheless, this was somewhat of a dark past of surrogacy arrangements in India. As of today, foreign nationals opting for surrogacy in India as well as commercial surrogacy in any form has been banned in India. The upcoming legislations, as we have discussed in the previous section seek to formalise the same. The Andhra Pradesh High Court in B.K. Parthasarthi v. Government of Andhra Pradesh[21] recognized reproductive rights as a fundamental right  and upheld ‘the right to reproductive autonomy’ of an individual as a part of their right to privacy. ART Regulation Bill, 2020 provides stringent punishments for sex selective surrogacy.[22] This is likely to protect a lot of surrogates from being forced to abort because of the sex of the child. According to S. 9 of Surrogacy (Regulation) Bill, 2017 too, no person organisation or surrogacy clinic may force a surrogate to abort except in such conditions as may be prescribed. These conditions should be in compliance with the Medical Termination of Pregnancy Act, 1971. By the said act, a pregnancy can be terminated within 12 weeks, if one registered medical practitioner, and 12-20 weeks, if at least two medical practitioners are convinced that the continuance of the pregnancy would involve a risk to the life of the pregnant woman or grave injury to her physical or mental health.

           Apart from this, the SRB, 2017 imposes an imprisonment for a term which shall not be less than ten years and with fine which may extend to ten lakh rupees against anyone who exploits a surrogate mother in any manner whatsoever. This provision creates a sense of security in the mind of women willing to act as surrogates. Arguably, one of the biggest highlights of the Surrogacy (Regulation) Bill, 2019 is the nature of S. 39 which does not follow the Indian legal system of “innocent until proven guilty”. By natural legal practice, the burden of proving guilt of the accused is on the plaintiff. However, S. 39 assumes that a woman or surrogate was compelled by her husband, the intending couple or any other relative, as the case may be, to render surrogacy services, procedures or to donate gametes for the purpose other than those specified under the clauses of the act and such person shall be liable for abetment of such offence under S. 37 (punishment for initiation of commercial surrogacy) and shall be punishable for the offence specified under that section (imprisonment for not less than five years and a fine which may extend to up to 5 lakh rupees) unless the contrary is proved. In addition, all offences under the act shall be cognizable, non-bailable and non-compoundable. The reasoning behind this may be based on the vulnerability of the surrogate mother due to the nature of surrogacy procedure. When it comes to the ensuring good health of the surrogate mother, the responsibility doesn’t and thus, mustn’t cease after the baby is delivered as post-partum complications are common and can affect the surrogate mentally, physically and financially. Hence, The SRB, 2020 extends the insurance cover for a surrogate mother from 16 months to 36 months.

          Despite all these provisions, there are some facets that need critical evaluation and an eventual inclusion in the bill. The Andhra Pradesh High Court in B.K. Parthasarthi v. Government of Andhra Pradesh[23] recognized reproductive rights as a fundamental right of a woman and upheld ‘the right to reproductive autonomy’ of an individual as a part of their right to privacy. This means that a woman’s reproductive rights and her right to bodily autonomy come under the ambit of Art. 21 of the Indian Constitution. The latest drafts of the bills only allow a married Indian woman between the age of 25-35 years who has already had a child and is mentally and physically fit to act as a surrogate, only once in her lifetime. It is arbitrary in terms that it doesn’t empanel single women or childless married women who are physically and mentally fit to be surrogates. In fact, married women with children already have a number of responsibilities and may even face some restrictions from their husbands while deciding whether to act as a surrogate or not. Secondly, although commercial surrogacy, as we discussed earlier in this paper, proved to be detrimental to women, it was a rich source of income for women, especially ones from financially weak households. That’s not to say that commercial surrogacy is justified. However, in appreciation of the surrogate mother’s sacrifices, she should receive some amount of compensation over and above reimbursement of other expenses. The Parliamentary Standing Committee that the Surrogacy (Regulation) Bill, 2016 was referred to put forth that the bill “is based more on moralistic assumptions than on any scientific criteria,” and that “all kinds of value judgments have been injected into it in a paternalistic manner.” The committee suggested replacing “altruistic” surrogacy with “compensated” surrogacy as it reckoned surrogate mothers should be paid reasonable compensation within a range of payments.[24]

Conclusion

After going through the malpractices related to surrogacy, the ups and downs, debates and discussions, multiple amendments, The Surrogacy (Regulation) Bill, 2020 and the Assisted Reproductive Technology Regulation Bill, 2020 are finally on their way to become concrete legislations that will, let’s hope, regulate the surrogacy procedures in the country and establish a free, yet secure ART environment. Even so, the defects and shortcomings of the bills should be studied and deliberated upon by Rajya Sabha before approving them. With the establishment of National Surrogacy board at the central level, State Surrogacy Boards for respective states and other appropriate boards for Union territories, a constant check on the sector is definite. Yet, at the end of the day it all boils down to how these bills, if enacted, are implemented and accepted.

Citations:

[1] Infertility, National Health Portal, available at https://ift.tt/3h22ut7., Last seen on 02/08/2020.

[2] N. Lal, India’s Hidden Infertility Struggles- Behind India’s booming population is another story: declining fertility rates and desperate couples. The Diplomat(30/05/2018), available at https://thediplomat.com/2018/05/indias-hidden-infertility-struggles/,  last seen on 02/08/2020.

 [3] Baby Manji Yamada v. Union of India & Anr., (2008) 13 SCC 518.

[4] About Surrogacy- Types of Surrogacy, Surrogate.com, available at https://ift.tt/2GDNcyr, last seen on 02/08/2020.

[5]SURROGACY (REGULATION) BILL, 2020, Manifest IAS, available at  https://ift.tt/3h6VaN9, last seen on 03/08/2020.

[6] Wellness and Medical Tourism, Ministry of Tourism, Government of India, available at https://ift.tt/2ZfzNmC, last seen on 04/08/2020.

[7] Supra 3.

[8] Part IV, Ch. 3, S. 1, Art. 772 (1), Civil Code 1896, (Japan).

[9] Japan gate-pass for baby Manji, The Telegraph online (17/10/2008), available at https://ift.tt/35h6ALN, last seen on 04/08/2020.

[10] Jan Balaz Vs. Anand Municipality & Ors., Letters Patent Appeal No.2151 of 2009.

[11] 228th Law Commission of India Report, Need for legislation to regulate Assisted Reproductive Technology clinics as well as rights and obligations of parties to a surrogacy, 26 27 (2008), available at https://ift.tt/2bUqPzt, last seen on 05/08/2020.

[12] Prabha Kotiswaran and Sneha Banerjee, Tracing the journey, and flaws, of the surrogacy bill, Hindustan times (16/01/2020), available at https://ift.tt/2Szb3D0, last seen on 05/08/2020.

[13] Ibid.

[14] hereinafter referred to as SRB, 2020.

[15] hereinafter referred to as ARTR, 2020.

[16] R. K. Bangia, Indian Contract Act, Allahabad Law Agency, Haryana (14th edn.- 2009) p. 82.

[17] The SRB, 2020 prescribes a 36 month insurance cover.

[18] L. Ahlsarmadi, The Rights and Obligations of parties to a Surrogacy Contract, 4 Interdisciplinary Journal of Contemporary Research In Business 164, 170 (2012), available at https://ift.tt/2R1F9gH, last seen on 06/08/2020.

[19] Ibid at 172.

[20] D. Munjal-Shankar, COMMERCIAL SURROGACY IN INDIA: VULNERABILITY CONTEXTUALISED, Volume no. 58 Journal of the Indian Law Institute 350, 356 (2016).

[21] B.K. Parthasarathi vs Government Of A.P. And Others, 2000 (1) ALD 199, 1999 (5) ALT 715.

[22] Cabinet approves the Assisted Reproductive Technology Regulation Bill 2020, PM INDIA, available at https://ift.tt/2ZcLCtR., last seen on 09/08/2020.

[23] B.K. Parthasarathi vs Government Of A.P. And Others, 2000 (1) ALD 199, 1999 (5) ALT 715.

[24] S. Kumar, India’s Proposed Commercial Surrogacy Ban Is an Assault on Women’s Rights, The Wire (09/11/2019), available at https://ift.tt/2ZacMkU, last seen on 11/08/2020.

Author:

Aditya Shete is a 2nd year student of BALLB at ILS Law College Pune.

His areas of academic interest include- Bio-ethics, International Law, IPR, Constitution and Criminal law. Aditya aspires to pursue a career in litigation.

The post Analysis: Surrogacy Procedures in India and the Laws appeared first on Legal Desire.

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[iasshikshalove]

Daily Current Affairs 18th March 2020

UIDAI CAN ISSUE NOTICE ON COMPLIANT

UIDAI:

Unique Identification Authority of India is a statutory authority established on 12 July 2016 by the Government of India under the jurisdiction of the Ministry of Electronics and Information Technology, following the provisions of the Aadhaar Act 2016.

The UIDAI is mandated to assign a 12-digit unique identification (UID) number (Aadhaar) to all the residents of India.

The UIDAI was initially set up by the Government of India in January 2009, as an attached office under the aegis of the Planning Commission.

Aadhaar:

Aadhaar means foundation, therefore it is the base on which any delivery system can be built.

Aadhaar can be used in any system which needs to establish the identity of a resident and/or provide secure access for the resident to services/benefits offered by the system.

Aadhaar Seeding:

· This is the process of linking the Aadhaar in various beneficiary databases.

· Examples include linking of Aadhaar to the Bank Accounts, to Pension ID for Pensioners and to Job Card Number of NREGS Wage Seekers, etc.

Aadhaar bill 2016:

The Aadhaar (Targeted Delivery of Financial and Other Subsidies, Benefits and Services) Bill, 2016 was introduced by Minister of Finance, Mr. Arun Jaitley, in Lok Sabha on March 3, 2016.

The Bill intends to provide for targeted delivery of subsidies and services to individuals residing in India by assigning them unique identity numbers, called Aadhaar numbers.

Eligibility:

Every resident shall be entitled to obtain an Aadhaar number.

A resident is a person who has resided in India for 182 days, in the one year preceding the date of application for enrolment for Aadhaar.

Offences and penalties:

A person may be punished with imprisonment upto three years and minimum fine of Rs 10 lakh for unauthorised access to the centralized data-base, including revealing any information stored in it.

If a requesting entity and an enrolling agency fail to comply with rules, they shall be punished with imprisonment upto one year or a fine upto Rs 10,000 or Rs one lakh (in case of a company), or with both.

Objectives:

Aadhaar Act provides statutory backing to Aadhaar, through which the government plans for targeted delivery of subsidies and services by assigning unique identity numbers to individuals residing in the country.

The Aadhaar will help in better targeting of subsidies as leakage through impersonation and duplication of identities can be eliminated.

Salient provisions:

It has been made obligatory for a person to possess Aadhaar to receive various forms of state subsidy and assistance.

However, if a person does not have an Aadhaar number, the government will insist to apply for it, and in the meanwhile, provide alternative means of identification.

Biometric information and other biological attributes will be used only for the enrolment and authentication of Aadhaar.

It should not be shared or displayed publicly except for the purposes specified by regulations.

Two cases when the information of an individual are revealed:

In the interest of national security:

Directions for revealing information may be issued by a joint secretary in the central government.

In such cases, Aadhaar number, biometric information, demographic information and photograph are revealed.

Such decisions to reveal the information will be valid for six months and will be reviewed by an Oversight Committee consisting of Cabinet Secretary, Secretaries of Legal Affairs and Electronics and Information Technology.

On the order of a court:

Aadhaar number, photograph, and demographic information may be revealed by a court’s order.

Aadhaar and Other Laws (Amendment) Bill, 2018:Supreme court verdict:

It upheld Aadhaar but limited its use for only certain subsidies and schemes funded by the Consolidated Fund of India.

The court disallowed private companies from asking for Aadhaar for authentication.

The amendments now seek to work on some of the restrictions imposed by the court.

Objective:

The Bill seeks to amend at least 27 sections of three existing laws. These are:

The Aadhaar (Targeted Delivery of Financial and Other Subsidies, Benefits and Services) Act, 2016

The Indian Telegraph Act, 1885

The Prevention of Money Laundering Act, 2002

The most important changes are to

(i) Allow children the chance to exit the Aadhaar ecosystem once they turn 18 years old

Expand the scope of Aadhaar being used by entities that was restricted by the Supreme Court

Create a UIDAI fund

Provide legal backing for Aadhaar to be used voluntarily as proof of identity to open bank accounts and for mobile phone SIM cards

Other amendments:

In compliance with the SC’s order, only High Courts (not district courts) can ask for disclosure of Aadhaar-related information.

Only an officer of the rank of Secretary (not Joint Secretary, as earlier provisioned) can issue directions for such information in the “interest of national security”.

The changes have made provisions for the use of virtual IDs to conceal the actual Aadhaar number of an individual.

Section 57 of the Aadhaar Act relating to use of Aadhaar by private entities has been omitted, as it was struck down by the SC.

Why in News?

The government informed the Lok Sabha that the Unique Identification Authority of India (UIDAI) might issue a show-cause notice on receipt of a complaint from “any person” or law enforcement agencies to ascertain if Aadhaar was procured through fraudulent means or by submitting false or fake documents.

In case the allegation is found to be correct, after a due inquiry, the Aadhaar number is omitted [cancelled] or deactivated [suspended].

As the case may be, in accordance with Regulations 27 and 28 of Aadhaar (Enrolment and Update) Regulations, 2016.

ABORTIONS TILL 24 WEEKS FOR SPECIAL CATEGORIES:

MTP ACT, 1971:

The Medical Termination of Pregnancy (MTP) Act 1971 — a law that was considered ahead of its times — legalized abortion in India up to 20 weeks of pregnancy.

Based on certain conditions and when provided by a registered medical practitioner at a registered medical facility.

Conditions under the MTP Act under which a pregnancy may be terminated are continuation of the pregnancy would involve a risk to the life of the pregnant woman or cause grave injury to her physical or mental health.

Also, substantial risk that the child, if born, would be seriously handicapped due to physical or mental abnormalities.

pregnancy is caused by rape (presumed to constitute grave injury to mental health) and pregnancy is due to failure of contraceptive in a married woman or her husband (presumed to constitute grave injury to mental health).

Why is it important to amend the MTP Act 1971?

Abortion was legalised 50 years ago, yet 10 women die every year as a result of unsafe abortions – making unsafe abortions the third-leading cause of maternal deaths in the country.

Other barriers to safe abortion include the implementation of :

As result of which doctors hesitate to provide abortion services to women and young girls.

This denies the reproductive rights of women(as abortion is considered an important aspect of the reproductive health of women).

One of the criticisms of the MTP Act, 1971 was that it failed to keep pace with advances in medical technology that allow for the removal of a foetus at a relatively advanced state of pregnancy.

The original law states that, if a minor wants to terminate her pregnancy, written consent from the guardian is required. The proposed law has excluded this provision.

The Protection of Children from Sexual Offenses Act, 2012 (POCSO Act).

The Pre-Conception Pre-Natal Diagnostic Techniques Act, 1994 (PCPNDT).

Note:

Before 1971, abortion was criminalized under Section 312 of the Indian Penal Code, 1860, describing it as intentionally ‘causing miscarriage’.

MTP (Amendment) Bill 2020:

Lok sabha has passed Medical Termination of Pregnancy (Amendment) Bill, 2020 to amend the Medical Termination of Pregnancy Act, 1971.

Salient features of proposed amendments:

Proposing requirement for opinion of one provider for termination of pregnancy, up to 20 weeks of gestation and introducing the requirement of opinion of two providers for termination of pregnancy of 20-24 weeks of gestation.

Enhancing the upper gestation limit from 20 to 24 weeks for special categories of women which will be defined in the amendments to the MTP Rules and would include ‘vulnerable women including survivors of rape, victims of incest and other vulnerable women (like differently-abled women, Minors) etc.

Upper gestation limit not to apply in cases of substantial fetal abnormalities diagnosed by the Medical Board. The composition, functions and other details of Medical Board to be prescribed subsequently in Rules under the Act.

Name and other particulars of a woman whose pregnancy has been terminated shall not be revealed except to a person authorised in any law for the time being in force.

The Medical Termination of Pregnancy (Amendment) Bill, 2020 is for expanding access of women to safe u legal abortion services on therapeutic, eugenic, humanitarian social grounds.

The proposed amendments include a substitution of certain sub-sections, insertion of certain new clauses under some sections in the existing Medical Termination.

[eportfolionhipham]

Cultural, Legal, and Ethical Issues in Health Care

This I Believe

Rights of patients and physicians

1. Patient autonomy, truth-telling, and confidentiality

            I believe that it’s important for providers to protect the patient’s information. I work in a lab as a medical technologist and here, we have a very strong emphasis on HIPPA laws and patient confidentiality. We take drastic measures in order to ensure that the privacy of our patients is protected. As tedious as it is to go through these hoops to protect our patients, I completely agree with why we do it. I think a patient’s health is a very personal thing. For example, if someone has an illness they contracted from having intimate relations with someone else, that’s something that is very personal and private. If something like that happened to me, I would be very distraught if that information was disclosed to parties that I did not approve. I’m trusting that I can seek the care I need without having to feel ashamed or judged. If a patient cannot fully trust a physician, there are high chances the patient will not seek the medical care that they need for fear of judgement. This could result in someone passing away even though it is completely curable or preventable.  

2. Medical research ethics and informed consent

            For any type of research, whether it’s medical based or not, it is always important to obtain informed consent. I think it’s very important that the person being evaluated for the research knows completely what they are getting themselves in to. Looking at the history of medical research, we can easily see why this concept is so important. Back in the day before ethic laws enacted to protect patients, doctors were allowed to perform experiments on patients without consent. These practices occurred most frequently in insane asylums. There was no reasonable justification for the cruel experiments, nor were the experiments controlled. Many who were coerced into participating, were often permanently damaged or murdered. As someone who graduated in a research focused field, I understand the importance of wanting to discover something amazing. With that being said, it’s extremely difficult to perform proper experiments. There are tons of guidelines that must be followed, especially if humans are involved in the trials. However, even though it’s difficult, I’d rather conduct a successful experiment without any lives lost, than conduct one where someone passes away.

Controls

3. Genetic control

            I don’t completely agree with the idea of genetic control. I’m assuming when we talk about genetic control we are talking about modifying someone’s genes, or an infant’s genes in order to take away specific unwanted traits. This concept holds valuable potential to cure diseases, or even eradicate diseases, but I don’t trust it to not be abused. At one end I would like to see it eradicate diseases and prevent babies from being born with detrimental illnesses. However, on the other end, I don’t trust human kind with this technology. In a time where race and violence is still so prevalent, I don’t trust people to not abuse this tool and use it for selfish superficial purposes. For example, someone wealthy wanting to ���create” the perfect baby. To me this concept is absolutely absurd. It’s so absurd that you’d imagine that something like this can’t be legal, but something similar to this is already occurring. In China, there is a lab that advertises specializing in helping you create the perfect baby. They don’t do this by genetic modification, instead they hire surrogates that are superficially beautiful. So essentially you’re picking the traits of your baby depending on what your surrogate looks like. This is wrong to me. I can understand having a surrogate because you can’t have children of your own, but to actively pick traits just seems wrong.

4. Reproductive control

            I personally think this applies to women. I think we should have the right to protect ourselves or take measures to control our own reproductive systems. Some religions out there are completely against this, and I can understand why, because many of them practice the idea of abstinence. However, you can practice abstinence and still want to take birth control. There are many benefits of taking birth control, not just for its main purpose of preventing reproduction. When I was 14, and a virgin, I had the worst periods. Every girl experiences this milestone differently, and my experience was horrendous. I was in a lot of pain, not to mention how long the pain would last. Most women usually have their menstruation period be roughly around 5-7 days. Mine would last about half the month. It was absolutely traumatic. My mom took me to the doctors and I was placed on birth control in order to control my period better. It was beneficial for me and made my life a lot better. I honestly can’t imagine what it would be like if my mom did not approve of my taking birth control just because it prevents reproduction as well. I would be in so much pain for nearly the entirety of my life.

Terminations

5. Abortion

            Over the years I’ve really flipped flopped on my opinions of abortion. When I was in my teen years, the fear of being young and pregnant terrified me. So the idea of abortion was a heaven sent. However, as I grew up my experiences changed me. My step mom was pregnant and she had a miscarriage. One in every three women miscarry their first child. This is very disheartening and a lot of women suffer because of this. A lot of women also lack the proper health conditions to have their own babies as well. So with this in mind I think that rather than abortion, putting the baby up for adoption seems like the better option. However, I don’t judge nor have a negative opinion of women that choose to have abortions. Every woman should have the right to determine what she does to her body, this includes terminating a pregnancy. If she decides she doesn’t want to put her body through that kind of growth, than that’s completely fine. Pregnancy, not to mention being extremely painful, is also terrifying when you consider that you’re responsible for the growth of another being. Some people are not ready for this responsibility and I think that is completely understandable. I’d rather the person terminate the baby than do something reckless during the pregnancy to cause permanent problems to the unborn baby.

6. Treating or terminating impaired infants

            My opinions of early unborn terminations are a lot more lenient than my opinion of a sick infant that is almost fully developed. I think to know that a baby is sick and then deciding to terminate is a little wrong. If there is a treatment possible for the baby, I don’t believe in terminating it. Healthy babies in general are a lot of work, and understandably sick babies are even more work than that. So it can seem a little daunting to have a sick baby, but I don’t think by this point that it’s right to be scared and back out. If you’ve decided to have a baby, and the baby happens to come out sick, you should take responsibility. However, I know that for some cases, the illness is severe enough that terminating the infant would be an act of kindness. As sad as that sounds, some illness can cause such excruciating pain that it’d be cruel to let the child suffer through that. So when I talk about not terminating a sick infant, I strictly mean for those cases where we have medical treatments available and it’s completely possible to have the infant survive and thrive.

7. Euthanasia and physician-assisted suicide

            I 100% support the practice of physician assisted suicide, but only for those that are terminally ill and suffering. If you hate your life and are depressed, I think counseling is the better course. My uncle suffered through pancreatic cancer. It was truly painful to see how much pain he was in. If you can imagine, he was this big buff guy, and by the end of his life he resembled a person who’s been starved for days. He constantly asked for the doctors to stop his treatment and to let him pass away. My family was very conflicted with this and there was a lot of arguing. My uncle’s medical decisions were legally up to my aunt. He gave her the rights to make the decisions for him. Which meant that when she was faced with whether or not she should stop his treatments, she struggled a lot. He was not in his right mind by this point and was just in a lot of pain. My aunt however, did not want to let go. In the end she chose to continue treatment for my uncle. He eventually passed away. Her reasons for continuing his treatments were because she couldn’t let him go, but he was completely ready to go. I don’t think my aunt is a bad person at all, but I do think that decision was selfish. I wanted to respect his wishes and let him go peacefully, not put him through more treatments that made him feel terrible. It wasn’t my decision, and even if I don’t agree with my aunt’s decision, it’s a terrible one she had to make in the first place. She was placed in a tough position, anyone would’ve struggled with this. I don’t believe her decision was wrong either.

Resources

8. Organ transplants and scarce medical resources

            This may seem a little off topic, but I support the tremendous amount of money it takes to continue the preservation of endangered plants and animals. I believe this because if we take into consideration this problem of scarce resources, we can see that we need to continue research into sustainable alternatives. Having to wait for someone to donate an organ is a really sad thing to think about. The patient usually suffers for a long period of time on the waitlist, and even if they obtain the new organ they need, it was probably from someone who passed away. Having to wait on someone else to die in order to live, is a very eerie concept. However, I think that if we invest our time into alternatives and artificial organs we can reduce the amount of patients on the transplant list, whilst keeping our planet healthy and thriving. The only way for this to be possible is to have further research in to alternatives. How would we find an alternative without first conserving our resources to make this research possible? The answer is we can’t. The amount of animals and plants that go extinct is proportional to the decrease in potential revolutionary discoveries.

  9. Distributing health care (How it should be allocated based on age/status/ability to pay)

            I come from Vietnam and my parents didn’t move to the U.S. until I was about 2 years old. Before we came to America, our healthcare was obviously based in Vietnam. I was fortunate enough to have been born very healthy, but my brother did not have the same fate. However, because we had money, we were able to afford the medical care needed for him. The first thing that for profit clinics and hospitals in Vietnam ask is how the patient will be paying for the care. Before they even let you sign papers to see a doctor or even knowing how much it would cost to treat you, the payment options are handed out first. They will literally do a check to make sure that you’re wealthy enough to afford medical care. My family was fortunate enough to afford what we needed, but as you can imagine, many other people in Vietnam aren’t as fortunate. Hospitals in Vietnam would let you die in their lobby than treat you pro bono. This experience is the reason why I feel like universal healthcare is so important. I think healthcare should be given to those who need it despite how much money they have. Obviously I think there should be a focus on levels of severity when seeking medical attention, but I don’t agree with turning people down for lack of money. I also don’t agree with making someone bankrupt for trying to survive and seek medical care. I don’t know how providers can take an oath, yet let someone die or ruin the rest of their lives just for medical treatment.

  Challenges

10. Health care for women

            I feel like the challenges for women healthcare right now is very prominent. I think in our society, it’s tough to be a woman. There’s so much judgement on every decision we make and there’s also a lot of people trying to make decisions for us. I never understood how someone can judge or tell a woman what she can do with her own body without first experiencing it themselves. For example I don’t know why it’s up to someone other than a specific individual, to decide whether or not they can take birth control. Every person has a different response to common health issues. Periods are different for every girl, pregnancies are different for every woman, and the body’s response to these things are not as predictable as they seem. Sometimes women need the extra help from medications to control painful health conditions. You can’t just make the assumption that someone is taking birth control just to prevent reproduction. You wouldn’t judge or make laws preventing someone from taking Tylenol for headaches when it’s mainly meant for fevers, so you shouldn’t judge a person for taking birth control. You don’t know why someone is making certain health decisions, so it’s important to stay out of their business.

11. Health care for minorities 

            Growing up as a minority in the U.S. the healthcare system was very hard to navigate. I remember being merely 7 and having to translate difficult medical terminology to my parents because we could not find a doctor that could translate. Obtaining healthcare in the U.S. wasn’t difficult like it is in Vietnam, but understanding it was a different story. I recently had a little cousin pass away, and one of the difficulties and reasons why she passed away was because of the lack of understanding of her disorder. Her parents did not speak English very well, so their understanding of her disorder was solely based on what my little cousin was telling them. However, my little cousins’ understanding of her own disorder was as much as you would imagine a 20 year with no medical experience could comprehend. She had Lupus and was very nonchalant about the severity of it. She was not clearly understanding the repercussions of not being attentive to her condition. On top of that, because she was so nonchalant about her condition, when describing to her doctors how she “felt” she came off as fine. Her parents not understanding the severity either, trusted her judgement, and at the end of it all, she passed away due to preventable symptoms of Lupus. I think that the healthcare system is not as clear for minorities as it is for the majority. Especially, if English is something they are not fluent with.

12. Health care for and responsibilities of those with AIDS/HIV

            Providing healthcare for those with AIDS/HIV is a no brainer; they should receive medical care. There’s not much else I can add to that because to have AIDS or HIV is to be sick and need medical attention. I don’t find people who have it to be different from others with terminal cancer. As far as responsibilities goes, it seems a little vague as to what you’re asking, but I think those with transmittable diseases should be held accountable in terms of not spreading the disease. The laws put in place for those who have the illness to report it to those they intend to be intimate with, is fair. I can see where some might find that this goes against patient confidentiality, but I think your right to privacy ends when you’re choosing to harm someone else. The law doesn’t state that they will publicly be announced, it’s lenient, and allows the specific person to make the call of who to tell. So I think it’s important to note that their privacy is being protected. They make the decision of who they tell. If they want to be intimate, then they are choosing to tell about their illness. If they didn’t want to disclose this information, then they should make the decision to not be intimate.

[millerjack537]

The Life Saving Medical Apparatuses

By Peter Kennedy

The world is full of surprises and wonders which is never limited. So long as something is found under the sky, it could contain its own wonder even in little ways. Some may remain a mystery and unrevealed yet some known wonders never fail to impress the majority. One common way of unveiling is uncovering the position of babies inside the womb through Leopold maneuver. Technologically enhanced types of machinery used to uncover the wonders of children left unborn in the earliest stages were accessible to check and view the status of these precious beating organisms. Abdominal ultrasounds are particular machines powerful enough to view hidden organisms placed inside abdomens and are usually intended to review the status of health and the gender. Electrically powered at most times, this can detect early illness symptoms and those will get prevented even before the carrier is born. The ultrasound device determines the gender and health status. The devices were electrically powered, this searches for symptoms with regard to expected illnesses. Thus, if some may get found, prevention is readily made to prevent it from worsening. The reproduction of all creatures is done in various ways. The school of fish, for example, grows bigger because of eggs produced by elders and adding more to its population mainly becoming a source of livestock. Human beings, on the other hand, procreate whilst mammals breed similarly to how a man does. The reproduction of all living creatures is acted in many varying ways. The schools of fish grow bigger when eggs are reproduced by older fish and become added to the population which primarily becomes an overflowing source of livestock. The human population multiplies differently through procreation and similarly goes to breeding mammals. The buildings crafted to intentionally providing comfort and shelter for residing parties is called houses. However, if families live inside it and sharing genuine feelings leaving no one behind, it then becomes lively and protective homes. A house built but stays empty are never treated as homes without residents inside. The medical field apparently is complicated and divided evenly ensuring all topics will get covered while studies are thoroughly focused. Professionals in these fields are generally called doctors. Experts who should always earn respect due to an unmatched passion they have fuelling them to help those who them. The medical study transparently is complicated enough and to lessen the burden, divisions are made to possibly allow more focus and enhancements of each specified topic and ensuring great resolution all the time. Professionals earning degrees in fields are generally labeled as doctors. Experts expecting to earn respect for such unmatched vision and drive that saves millions of lives through their earned skill. Apparatuses are invented to enable solutions for problems which in old generations were thought as unfixable. An easy way of showing gratitude to inventors is operating the mentioned appropriately and handled with care. Just imagine going back to times when everything remains impossibly accessed and civilization is left nowhere. The hardships are now easily solved using assisting devices compared to having no resources at all.

About the Author:

When you are searching for information about a Leopold maneuver, come to our web pages today. More details are available at https://ift.tt/2MOCtma now.

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[clusterassets]

New world news from Time: Japanese Man Granted Sole Custody of 13 Children He Fathered With Thai Surrogate Mothers

A Japanese man who became embroiled in a “baby factory” scandal four years ago has been granted sole custody of 13 children he fathered with Thai surrogate mothers.

Mitsutoki Shigeta, 28, won custody on Tuesday, after taking the Thai government to court over his paternal rights, AFP reports. The court ruled that Shigeta, reportedly the son of a Japanese business tycoon, has ample means to care for such a large family.

“For the happiness and opportunities the 13 children will receive from their biological father — who does not have a history of bad [behavior] — the court rules them to be the plaintiff’s legal children,” Thailand’s Central Juvenile Court said in a statement.

In 2014, Shigeta, who is unmarried, was at the centrt of an international scandal after a luxury apartment in Bangkok was raided and found to contain nine children and their seven 24-hour nannies. It soon emerged that Shigeta had fathered 19 children in total, with 13 babies born to surrogate mothers living in Thailand, and six living in Cambodia and Japan. Police told AFP that he had paid the Thai surrogate mothers between $9,300 and $12,500 each.

His case contributed to the international outcry against Thailand’s “rent a womb” industry, and led to the Protection for Children Born Through Assisted Reproductive Technologies Act (ART Act) in 2015, preventing foreigners from paying for Thai surrogates.

February 20, 2018 at 07:08PM ClusterAssets Inc., https://ClusterAssets.wordpress.com

[cnrgcommons]

Manager of Clinical Quality Improvement

Planned Parenthood Columbia Willamette (PPCW) is committed to providing, promoting, and protecting access to sexual and reproductive health care in Oregon and Southwest Washington. Since 1963, PPCW has provided a broad range of sexual and reproductive health care, including family planning, preventative care, and other medical services; trained and educated community members on issues of sexuality; and advocated for the protection of reproductive rights and freedom in Oregon and Southwest Washington. Each year, more than 58,000 women, men and teens visit a PPCW health center, located in NE and SE Portland, Milwaukie, Beaverton, Salem, and Bend, Oregon; and Vancouver, Washington.

We believe that we are leading a movement for reproductive health care and education, and we are looking for people who want to help us transform the world. As our Manager of Clinical Quality Improvement, we can offer you:

-          A supportive atmosphere and collaborative environment

-          A focus on education and prevention

-          Organizational emphasis on high-quality practices

-          The unique chance to combine mission with medical practice

-          A gratifying personal experience

Position Details: This is a non-represented, exempt position.

Schedule: Full-time (37.5 hours/week).

Location: NE Portland

Benefits: 4.2 weeks Paid Time Off (starting rate for first 2 years), excellent employer-paid Medical, Dental, and Vision Insurance, FSA, Short and Long Term Disability, Life AD&D Insurance, 403b Retirement Fund, and employee assistance program.

Compensation: $73,500 + DOE.

Minimum Qualifications:

• Licensure as a registered nurse and BSN degree required.  • Five (5) years progressive clinical and/or administrative experience, quality focus desired. • Prior supervisory or management experience in a related health care field. • Must have a current CPR certification. • Knowledge and experience in OSHA, CLIA, privacy laws, access, and release of information, quality and risk management and related guidelines and requirements. • Experience in Women’s Health preferred. • Professional, positive attitude with proven ability to contribute effectively to highly functioning work teams.

Application Process: This position will be open until filled; however, interviewing will likely begin no sooner than early May. Please refrain from inquiring about your application status until mid-May. Applications must be submitted online through our website - click “Apply Now” at the bottom of the listing. Applications submitted without a cover letter will NOT be reviewed. Please upload your resume and cover letter as one PDF in the submitted/additional documents section. Applicants who do not meet the above stated minimum requirements will not be considered.

Position Summary:

Under the supervision of the Director of Clinical Services, the Manager of Clinical Quality Improvement (CQI) is responsible for administering the affiliate’s clinical quality improvement program in accordance with customer and agency requirements.  This position monitors and ensures affiliate compliance with standards of quality patient care, PPFA accreditation standards, applicable state licensing requirements, and other applicable federal/state regulations.  The Manager of Clinical Quality Improvement monitors and analyzes the trends in documentation, treatment protocol and service delivery, and serves as the agency’s HIPAA Privacy Officer. This position oversees the department functions of all quality management and improvement services in PPCW health centers, including the following:

Clinical risk management

Incident reporting

Quality Improvement

Patient safety

Laboratory Services, CLIA

HIPAA

The Manager of CQI is responsible for objectively and systematically monitoring and evaluating the quality and appropriateness of patient care.  They pursue opportunities to improve patient care and satisfaction and assist in the resolution of problems that are identified.  Provides clinical support and training to the Case Management team, which includes both licensed and non-licensed staff.

Essential Functions:

Coordinate all quality management activities, relating directly to health center activities, including medical, EHR and clinical audits. Monitor and maintain audits on care and services; compile data and assist centers in developing corrective action plans.  This includes, but is not limited to, follow-up referrals, HIPAA, contraceptive management, special services, surgical procedures and consumer feedback.

Serve as agency HIPAA Privacy Officer.

Compile statistical data and write narrative reports summarizing quality assurance findings, for internal quality improvement purposes, and as required by PPFA,Title X, NAF, VFC, etc.

Document, evaluate and follow-up on any medical occurrences.  Oversee the Incident Reporting system per current ARMS guidelines. Prepare quarterly summary report for Medical Management Team and annual report for PPCW Board of Directors

Maintain legal hold system and coordinates release of information from medical records.

Provide ongoing training and develop training tools for all health center staff on Quality Management as it relates to clinical practice.

Conduct clinical safety meetings with the safety clinic assistants every other month.

Receive and relay all legal correspondence for review by Chief Operating Officer, Corporate Compliance Manager, ARMS and agency counsel as appropriate.

Manage laboratory services in conjunction with the Director of Laboratory Services ensuring quality and cost-effective lab services, including proficiency testing and applications, licensure applications, CLIA laboratory quality assurance assays, and associated report preparation and submission.

Ensure compliance with Vaccine for Children (VFC) program and other vaccine administration.

In collaboration with the Medical Management Team, PS Administation and the Chief Operating Officer, update appropriate departmental policies and procedures.

Assume responsibility for special projects or other duties as assigned.

Coordinate the Employee Exposure/Blood Borne Pathogen program in collaboration with Human Resources.

Additional reasonable tasks and responsibilities as assigned by supervisor.

Required Skills:

Leadership – Outstanding leadership with demonstrated excellent internal and external customer service skills and a commitment to providing the highest level of customer satisfaction

Strategic Thinking – Able to develop strategies in support of the organization and establish plans to execute

Business Knowledge – Thorough knowledge of agency standards, guidelines, policies, procedures. Understands products and services; knowledgeable of operations and fiscal responsibilities

Management – Plans resources, organizes and adjusts to achieve goals through collective efforts

Organization – Strong organizational skills. Able to manage multiple issues and projects as well as responding to unplanned issues.

Team player – Demonstrates behavior that brings people together to solve problems and achieve results Proven ability to contribute effectively to highly functioning work teams

Confidential – Able to manage information in a way that honors all parties; acts with integrity and professionalism

Communication Skills – Excellent verbal and written communication skills; articulate, professional, and able to communicate effectively with patients, all PPCW staff (administrative, clinical and non-clinical) and members of the community

Problem Solving/Objectivity – Must be analytical and a creative problem solver

Technology/Tools – Proficiency in NextGen, Microsoft Word, Excel and Power Point and Outlook.  Willingness and ability to adapt to change, including advances in technology

Travel – Required to travel to all health centers. Must have reliable transportation and a valid driver’s license

Employee Agreements:

Accountability – Takes personal responsibility for the quality and timeliness of work.  Accepts responsibility for mistakes and identify ways to improve.  Communicate expectations of others clearly and directly.  Complies with established policies, rules, and workplace expectations. 

Equity – Creates an inclusive and welcoming work environment by practicing equity, learning to appreciate difference, challenging inequity, and striving for justice.

Integrity – Performs and communicates in a truthful and ethical manner. Fosters a work environment that values and demonstrates trust and honesty.  Respects and maintains confidentiality.

Mission-Oriented – Work activities and priorities support the mission, strategic direction, and financial sustainability of the organization.

Relationship Building – Builds positive working relationships characterized by a high level of acceptance, cooperation, and mutual respect.  Promote collaboration and commitment within teams to achieve goals and deliverables.

Planned Parenthood Columbia Willamette is an equal employment opportunity employer and is committed to maintaining a non-discriminatory work environment.  We do not discriminate against any employee or applicant for employment on the basis of race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, national origin, marital status, age, mental or physical disability, genetic information, application for workers’ compensation benefits, use of statutory protected leave, veteran or military status, pregnancy, union activity, or any other characteristic or status protected by applicable federal, state or local laws.  Planned Parenthood is committed to creating a dynamic work environment that values diversity and inclusion, respect and integrity, customer focus, and innovation.

[marymosley]

Analysis: Surrogacy Procedures in India and the Laws

A country like India with a suspiciously declining fertility rate of around 2.2 (births per woman) witnessed a rise in infertile couples opting surrogacy as an alternative reproductive choice in the last decade. Globally, 15 % of reproductive-aged couples are affected by infertility.[1] There are a number of factors that lead to infertility including, but not limited to- obesity, diabetes, mental stress, sexually transmitted infections, overuse of emergency contraceptives, hormonal imbalance, etc.[2] With a rapid boost in urbanisation and technology, these issues have jumped into the spotlight. Yet, surrogacy stays an under-developed field in the Indian legal context.

 The debate and discussion on surrogacy is as old as surrogacy itself. It has been quite a controversial issue owing to its complex nature and the abject lack of a just and firm legislation to regulate it. As and when posed with a legal complication and a dire need for a legislation, the Legislature and the judiciary have made attempts to atone and introduce a framework for surrogacy clinics to operate. We shall discuss this later into the paper. However, none of these efforts have reached fruition as of yet and the ambiguity around the subject remains intact.

Owing to all this, the vulnerability of a surrogate mother is the highest among the parties to a surrogate arrangement. There have been instances where the delivered baby was refused acceptance by intended parents due to divorce or some abnormality in the child. A landmark case that describes this scenario perfectly is the Baby Manji Yamada vs. UOI and Anr.[3] (2008) along with a few other cases which will later be discussed in this paper. Before delving into the rights and obligations related to surrogacy, let’s briefly understand what surrogacy is.

 What is Surrogacy?

In a nutshell, surrogacy is a system of assisted reproduction wherein the intended parents rely on a surrogate mother who is willing to carry and care for their baby until birth. Intended parents that are unable to conceive naturally use surrogacy to start or grow their families while maintaining their heredity. This could be because of infertility or some physical abnormalities/conditions of the biological mother that make it unsafe for her to carry the child. There are variations in surrogacy on the basis of Genetic relationship (Gestational vs. Traditional), Payment of the surrogate (Compensated vs. Altruistic), place of completion (Domestic vs. International), etc.

          Gestational Surrogacy vs. Traditional Surrogacy-

In gestational surrogacy, the child is not biologically related to the surrogate mother (gestational carrier). Instead, the embryo is created via in vitro fertilization (IVF), using the eggs and sperm of the intended parents or donors, and is then transferred to the surrogate. In contrast to this, in Traditional Surrogacy, the surrogate mother is artificially inseminated with the intended father’s or a donor’s sperm. Since the surrogate contributes her own egg and thus has a biological link with the baby, it is also called as ‘partial surrogacy’.[4]  

Compensated vs. Altruistic Surrogacy

When intended parents pay a surrogate mother compensation above and beyond reimbursement of her medical expenses for carrying their baby till birth, it is called compensated or commercial surrogacy. Altruistic Surrogacy, on the other hand, is when the surrogate mother gets no additional monetary compensation apart from for maintenance and other pregnancy related expenses. Most of these arrangements happen between close friends or relatives of the intended parents.

Surrogacy has proven to be a sigh of relief for infertile couples who go through the trauma of being unable to reproduce naturally. Regardless, it still isn’t a cake-walk and has psychological as well as social barriers that makes opting for surrogacy a tough call. Besides, commercial surrogacy, by the Surrogacy (Regulation) Bill, 2019 (passed by Lok Sabha), is on its way to be completely banned in India owing to a multitude of illegal rackets, unregulated procedures, legal complications and above all, the outright exploitation of the surrogate mother. The ban was partially imposed by ICMR on 28th September, 2015 by sending a letter notifying all clinics in India to disallow foreign commissioning parents to have babies through an Indian surrogate mother. Most states do not allow traditional surrogacy and delimit surrogacy agreements to altruistic and gestational forms. For eg., UK, Denmark, Australia, Canada and Greece permit only altruistic surrogacy while Germany, France, Italy and Sweden have a blanket ban on surrogacy.[5] India, on the other hand is still in the grey when it comes to a definite surrogacy regulations.

Brief History of Surrogacy in India.

On 3rd October, 1978, the successful birth of the first IVF baby Kanupriya alias Durga in Kolkata sowed the seed of surrogacy as an alternative reproductive technology (ART) in India. In the year 2002, commercial surrogacy was made legal in India. The technology developed and mushroomed in a way, that by 2012, India came to be known as the ‘Surrogacy Capital of the World’ having approximately a $500 million per annum market.[6] Couples from all over the world seeking surrogates at cheaper rates started flying to India. However, along with prosperity, came a plethora of legal and philosophical complications. Being an awfully unregulated sector, unsafe and unethical practices sprouted to meet the foreign demand.

Baby Manji Yamada v. Union of India[7], a landmark case that made the apex court question the validity of commercial surrogacy set into motion talks for having the country a just and solid legislation. In the said case, the biological parents, Dr. Yuki Yamada and Dr. Ikufumi Yamada came to India in 2017 and entered in an agreement with a surrogate mother in Anand, Gujarat. Subsequently, the surrogate baby was born on 25/6/2008. By this time, the intended parents, due to marital conflicts had separated and though it was agreed upon initially that the father would be granted custody if such a situation arose, Dr. Yuki’s visa expired and he had to fly back to Japan. Nonetheless, he tried to still claim the baby by applying for her passport, but the Japanese Civil Code[8] bore no recognition for surrogate children born to a woman of non-Japanese origin and thus, rejected his application.

At this point, the baby didn’t belong to anyone. Even the surrogate mother was absolved of rights and responsibilities with the delivery of the baby. Between this labyrinth of legal and diplomatic complications, Manji’s paternal grandmother, Emiko Yamada flew to India to foster the baby.  Soon, a Jaipur based NGO- SATYA moved Rajasthan High Court using the writ of Habeus Corpus claiming illegal custody of Manji by Emiko. The case advanced and the Court gave a four weeks notice to produce the baby before it. Seeking justice for herself and the baby, a helpless Emiko moved the apex court for intervention.[9] The court, inter alia, gave the government directions with respect to the grandmother’s visa extension and the baby’s passport grant. Later, The Regional Passport Office, Rajasthan issued a first of its kind Certificate of Identification which didn’t have a mention of nationality and mother’s name for the baby to expedite her transit to Japan. Ending the story on a happy note, Japanese Embassy granted the child a one-year visa on humanitarian grounds and Baby Manji and Grandma Emiko flew back to Japan.

This case, however influential, failed to address the outburst of commercial surrogacy and its ill-reaching impacts on poor women. On the other hand, it is laudatory that the court rendered its decision in time considering the predicament of the baby. Nonetheless, it put forth the dire need for a well-structured and inclusive legislation for surrogacy arrangements.

Another case similar to this is that of Jan Balaz v. Anand municipality and ors.[10] in which a German couple that followed the same process of trying to have a baby inexpensively through an Indian surrogate faced parental ownership issues. In this case, twin babies, Leonard and Nicolas were, by the order of the Gujarat High Court issued two overseas Indian passports. Since the babies were born in India, they were already established to be citizens of India by the S (3)(1)(c)(ii) of the Citizenship Act, 1955. The babies were allowed to return home after the parents successfully adopted them. They, nonetheless, remained citizens of India.

To counter these practices, the ICMR (Indian Council for Medical Research), in 2005, came up with a set of provisional guidelines- The National Guidelines for Accreditation, Supervision and Regulation of ART Clinics in India, which in furtherance, became the Assisted Reproductive Technologies (Regulation) Bill 2008 followed by a revised draft in 2010 and 2013. After much deliberation and research, In February this year, the Assisted Reproductive Technology (Regulation) Bill, 2020 was approved by the cabinet.

The 228th Law Commission report took suo motu cognizance of the issue at hand. It was titled, ‘Need for legislation to regulate Assisted Reproductive Technology clinics as well as rights and obligations of parties to a surrogacy’. It was chaired by Dr. Justice A.R. Lakshmanan. A few suggestions by the commission were[11]-

Surrogacy arrangements should be governed by contract between the parties, but such arrangements shouldn’t be for commercial purposes.

Birth certificate of the surrogate child should contain name(s) of the commissioning parent(s) only.

Right to Privacy of donor as well as surrogate mother should be protected.

Sex-selective surrogacy should be prohibited.

Cases of abortion should be governed by Medical Termination of Pregnancy Act, 1971.

          All of these efforts contributed substantially to form the draft of Assisted Reproductive Technology (Regulation) Bill, 2014. Apart from this Bill, in November, 2016, the Surrogacy (Regulation) Bill, 2016 was introduced in and passed by the Lok Sabha. It sought to confine surrogacy to non-commercial, altruistic and performed by a ‘close relative’. The bill was drafted in a way that it reflects the “ethos of the Indian people”.[12] However, this bill was further referred to a Parliamentary Standing committee (PSC) which suggested some pivotal changes like expanding the scope of being potential surrogate mothers to any willing woman and not just close relatives, raising the insurance cover, allowing compensated surrogacy, including live-in couples, NRIs, widows, divorced women, etc.[13] Ignoring most of these suggestions, a bill similar to the 2016 bill, the Surrogacy (Regulation) Bill, 2019 was passed by the Lok Sabha in August 2019. The Rajya Sabha considered it fit to refer the bill to a Select committee before passing it. After flood, storm and fire, today, we have The Surrogacy (Regulation) Bill, 2020 (introduced before the Parliament)[14] and the Assisted Reproductive Technology (Regulation) Bill, 2020 (Pending before Lok Sabha)[15]  that have the potential to legally transform the landscape of surrogacy in India. Let’s roll into analysing these bills vis-à-vis rights and obligations of parties to surrogacy arrangements.

Rights and Obligations of Parties to Surrogacy arrangements.

          The parties to Surrogacy ‘contract’ are the surrogate woman, her husband if she is married, the surrogate child and the intending parent(s).[16] A Surrogacy Agency and the donor may or may not be a party to the ‘arrangement’ depending on whether the intending couples choose to opt for one or not. In light of the drafts of the Surrogacy (Regulation) Bill and Assisted Reproductive Technology (Regulation) Bill, following are the rights and obligations of these parties-

The intended parents need to produce-

A certificate of proven infertility (of either or both) obtained from a district medical board in order to enter into a surrogacy contract. In the 2019 Surrogacy Regulation Bill, ‘infertility was defined as “the inability to conceive after five years of unprotected coitus or other proven medical condition preventing a couple from conception”. However, the 2020 bill seeks to delete this definition, since 5 years was too long a period to wait for a child.

An order concerning the parentage and custody of the child to be born through surrogacy passed by a court of the Magistrate of the first class or above, on an application made by the intending couple and surrogate mother.

An insurance coverage of such amount as may be prescribed[17] in favour of the surrogate mother from an insurance company or an agent recognised by the Insurance Regulatory and Development Authority established under the Insurance Regulatory and Development Authority Act, 1999.

An eligibility certificate issued by appropriate authority after ensuring the intending couple – is aged between 23-50 years in case of the female and 26-55 years in case of the male; is married for at least 5 years and are Indian citizens or Overseas Citizen of India (OCIs), People of Indian Origin (PIOs), Non Resident Indians (NRIs) and foreigner married to an Indian citizen; have not had any surviving child biologically or through adoption. Note that the last condition doesn’t apply if the intending couple have a child who is mentally or physically challenged or suffers from life threatening disorder or fatal illness with no permanent cure.

It is the obligation of the surrogacy clinic to explain thoroughly all known side effects and after effects of the procedure to the surrogate mother and get a written consent from her in the language she understands.

The commissioning couple is obliged to not abandon the child, born out of a surrogacy procedure, whether within India or outside, for any reason whatsoever, including but not restricted to, any genetic defect, birth defect, any other medical condition, the defects developing subsequently, sex of the child or conception of more than one baby, etc. They also aren’t allowed to avail services of more than one surrogate at a time.

A surrogacy clinic has to compulsorily register itself by making an application to an appropriate authority under the act. It can operate only after authorisation by the authority.

Neither of the parties to the surrogacy agreement can conduct, offer, undertake, promote or associate with or avail of ‘commercial surrogacy’ in any form; exploit or cause harm to the surrogate mother or child in any manner whatsoever; advertise or promote commercial surrogacy in any manner.

No person, organisation, surrogacy clinic, laboratory or clinical establishment of any kind shall force the surrogate mother to abort at any stage of surrogacy except in such conditions as may be prescribed.

The intended parents are bound by the surrogacy agreement to pay for the surrogate’s expenses that include expenses related to the entire medical procedure of surrogacy, expenses of feeding the embryo in the gestation period, the attorney’s fee (if appointed) and all other medical expenses as and when required.[18]

The surrogate is also obligated to nurture the child in her womb during the gestational period (this includes feeding herself well, regular visits to gynaecologists, proper medication, etc.) The surrogate is duty-bound not to engage in any act that may harm the foetus in any manner. At the same time, the surrogate and her husband are not allowed to have an extra-marital affair during the gestation period. The Surrogate has to hand over the baby, relinquishing all her parental rights, to the intended parents at the time decided in the agreement which may be right after delivery or after the breastfeeding period.[19]

Surrogate mother should be an ever married Indian woman between 25-35 years of age and shall have at least one live child of her own with minimum age of three years and should act as a surrogate for not more than one successful live birth in her life and with not less than two years interval between the two deliveries.

If the first embryo transfer fails, the surrogate shall undergo not more than two more embryo transfers for the same couple.

The child born through a surrogacy shall have-

The status of legitimate child of the commissioning couple (even if the married couple divorce).

Identical legal rights as a legitimate child born out of sexual intercourse.

Overseas Citizenship of India under Section 7A of Citizenship Act, 1955 if born to Overseas Citizen of India, People of Indian Origin or a foreigner married to an Indian citizen.

The right to ask for information, excluding personal identification, regarding the donor or the surrogate.

 [extracted from the Surrogacy (Regulation) Bill, 2019 and the Assisted Reproductive Technology (Regulation) Bill, 2017]

     All these rights and obligations of parties along with other provisions negotiated between the parties need to be drafted into a surrogacy contract which shall be legally enforceable.

State of the Indian Surrogate- the past, the present, the future.

          The Surrogacy (Regulation) Bill, 2016 defines a surrogate mother as “a woman bearing a child who is genetically related to the intending couple, through surrogacy from the implantation of embryo in her womb..”. Surrogacy is more than just an alternative way of conceiving babies. It involves sacrifices made by a woman out of her own free will to bless an unfortunate couple with a child and complete a family. In India, specifically, where surrogacy is limited to only altruistic means, a woman coming forward, ignoring social stigma to take up the enormous responsibility of fostering a child not belonging to her in her womb and then handing it over on delivery is worth a ton of praise.

          For years, in India, commercial surrogacy was practised freely without any regulation. This boosted the sector by leaps and bounds. India saw an exponential influx of foreign demands for surrogacy and to cater to it, an unregulated, uncontrolled practice of ‘renting wombs’ took seed and it put the surrogate mother in a highly vulnerable position. Diksha Munjal-Shankar conducted an empirical study[20] in 2014 at a renowned infertility clinic in Anand, Gujarat and it showed some findings that depicted the unfortunate status of surrogates then. It was found that most of the surrogates had received only basic education, belonged to poor households and didn’t have a monthly salary of more than Rs. 3000/month. They were drawn towards commercial surrogate motherhood only by the prospect of earning 10 times their normal monthly income since they received upto Rs. 3,75,000 from the surrogacy arrangement. However, the state in which the surrogate mothers were kept was way below adequate. They were kept in hostel rooms having single iron beds with 2.5-3 feet of distance between each. The food provided to them was below par and most of them complained about it. They weren’t allowed to leave the facility even for a simple stroll. This clearly violated their freedom of movement guaranteed under Art. 19 of the Constitution of India. Even if they felt like stepping out, the fear of social censure haunted them. Besides, the surrogates usually didn’t meet the commissioning couples during the gestational period. They had minuscule amount of mental and emotional support. The worst of all this was that the surrogates weren’t thoroughly adept with the surrogacy procedure and the agreement between the parties too, was in English. This put them in an ever more vulnerable position in the bigger scheme of things. After the delivery, the baby was immediately handed over to the commissioning parents and for the purpose of feeding the child, apparatuses were used to pump out the mother’s milk. These are still findings from just one study conducted in one clinic.

          There have also been instances of sex-selective abortions and post-delivery abandonment of the child due to some birth defect. All these findings point to the commodification of the surrogate mother and the surrogate child. Nonetheless, this was somewhat of a dark past of surrogacy arrangements in India. As of today, foreign nationals opting for surrogacy in India as well as commercial surrogacy in any form has been banned in India. The upcoming legislations, as we have discussed in the previous section seek to formalise the same. The Andhra Pradesh High Court in B.K. Parthasarthi v. Government of Andhra Pradesh[21] recognized reproductive rights as a fundamental right  and upheld ‘the right to reproductive autonomy’ of an individual as a part of their right to privacy. ART Regulation Bill, 2020 provides stringent punishments for sex selective surrogacy.[22] This is likely to protect a lot of surrogates from being forced to abort because of the sex of the child. According to S. 9 of Surrogacy (Regulation) Bill, 2017 too, no person organisation or surrogacy clinic may force a surrogate to abort except in such conditions as may be prescribed. These conditions should be in compliance with the Medical Termination of Pregnancy Act, 1971. By the said act, a pregnancy can be terminated within 12 weeks, if one registered medical practitioner, and 12-20 weeks, if at least two medical practitioners are convinced that the continuance of the pregnancy would involve a risk to the life of the pregnant woman or grave injury to her physical or mental health.

           Apart from this, the SRB, 2017 imposes an imprisonment for a term which shall not be less than ten years and with fine which may extend to ten lakh rupees against anyone who exploits a surrogate mother in any manner whatsoever. This provision creates a sense of security in the mind of women willing to act as surrogates. Arguably, one of the biggest highlights of the Surrogacy (Regulation) Bill, 2019 is the nature of S. 39 which does not follow the Indian legal system of “innocent until proven guilty”. By natural legal practice, the burden of proving guilt of the accused is on the plaintiff. However, S. 39 assumes that a woman or surrogate was compelled by her husband, the intending couple or any other relative, as the case may be, to render surrogacy services, procedures or to donate gametes for the purpose other than those specified under the clauses of the act and such person shall be liable for abetment of such offence under S. 37 (punishment for initiation of commercial surrogacy) and shall be punishable for the offence specified under that section (imprisonment for not less than five years and a fine which may extend to up to 5 lakh rupees) unless the contrary is proved. In addition, all offences under the act shall be cognizable, non-bailable and non-compoundable. The reasoning behind this may be based on the vulnerability of the surrogate mother due to the nature of surrogacy procedure. When it comes to the ensuring good health of the surrogate mother, the responsibility doesn’t and thus, mustn’t cease after the baby is delivered as post-partum complications are common and can affect the surrogate mentally, physically and financially. Hence, The SRB, 2020 extends the insurance cover for a surrogate mother from 16 months to 36 months.

          Despite all these provisions, there are some facets that need critical evaluation and an eventual inclusion in the bill. The Andhra Pradesh High Court in B.K. Parthasarthi v. Government of Andhra Pradesh[23] recognized reproductive rights as a fundamental right of a woman and upheld ‘the right to reproductive autonomy’ of an individual as a part of their right to privacy. This means that a woman’s reproductive rights and her right to bodily autonomy come under the ambit of Art. 21 of the Indian Constitution. The latest drafts of the bills only allow a married Indian woman between the age of 25-35 years who has already had a child and is mentally and physically fit to act as a surrogate, only once in her lifetime. It is arbitrary in terms that it doesn’t empanel single women or childless married women who are physically and mentally fit to be surrogates. In fact, married women with children already have a number of responsibilities and may even face some restrictions from their husbands while deciding whether to act as a surrogate or not. Secondly, although commercial surrogacy, as we discussed earlier in this paper, proved to be detrimental to women, it was a rich source of income for women, especially ones from financially weak households. That’s not to say that commercial surrogacy is justified. However, in appreciation of the surrogate mother’s sacrifices, she should receive some amount of compensation over and above reimbursement of other expenses. The Parliamentary Standing Committee that the Surrogacy (Regulation) Bill, 2016 was referred to put forth that the bill “is based more on moralistic assumptions than on any scientific criteria,” and that “all kinds of value judgments have been injected into it in a paternalistic manner.” The committee suggested replacing “altruistic” surrogacy with “compensated” surrogacy as it reckoned surrogate mothers should be paid reasonable compensation within a range of payments.[24]

Conclusion

After going through the malpractices related to surrogacy, the ups and downs, debates and discussions, multiple amendments, The Surrogacy (Regulation) Bill, 2020 and the Assisted Reproductive Technology Regulation Bill, 2020 are finally on their way to become concrete legislations that will, let’s hope, regulate the surrogacy procedures in the country and establish a free, yet secure ART environment. Even so, the defects and shortcomings of the bills should be studied and deliberated upon by Rajya Sabha before approving them. With the establishment of National Surrogacy board at the central level, State Surrogacy Boards for respective states and other appropriate boards for Union territories, a constant check on the sector is definite. Yet, at the end of the day it all boils down to how these bills, if enacted, are implemented and accepted.

Citations:

[1] Infertility, National Health Portal, available at https://ift.tt/3h22ut7., Last seen on 02/08/2020.

[2] N. Lal, India’s Hidden Infertility Struggles- Behind India’s booming population is another story: declining fertility rates and desperate couples. The Diplomat(30/05/2018), available at https://thediplomat.com/2018/05/indias-hidden-infertility-struggles/,  last seen on 02/08/2020.

 [3] Baby Manji Yamada v. Union of India & Anr., (2008) 13 SCC 518.

[4] About Surrogacy- Types of Surrogacy, Surrogate.com, available at https://ift.tt/2GDNcyr, last seen on 02/08/2020.

[5]SURROGACY (REGULATION) BILL, 2020, Manifest IAS, available at  https://ift.tt/3h6VaN9, last seen on 03/08/2020.

[6] Wellness and Medical Tourism, Ministry of Tourism, Government of India, available at https://ift.tt/2ZfzNmC, last seen on 04/08/2020.

[7] Supra 3.

[8] Part IV, Ch. 3, S. 1, Art. 772 (1), Civil Code 1896, (Japan).

[9] Japan gate-pass for baby Manji, The Telegraph online (17/10/2008), available at https://ift.tt/35h6ALN, last seen on 04/08/2020.

[10] Jan Balaz Vs. Anand Municipality & Ors., Letters Patent Appeal No.2151 of 2009.

[11] 228th Law Commission of India Report, Need for legislation to regulate Assisted Reproductive Technology clinics as well as rights and obligations of parties to a surrogacy, 26 27 (2008), available at https://ift.tt/2bUqPzt, last seen on 05/08/2020.

[12] Prabha Kotiswaran and Sneha Banerjee, Tracing the journey, and flaws, of the surrogacy bill, Hindustan times (16/01/2020), available at https://ift.tt/2Szb3D0, last seen on 05/08/2020.

[13] Ibid.

[14] hereinafter referred to as SRB, 2020.

[15] hereinafter referred to as ARTR, 2020.

[16] R. K. Bangia, Indian Contract Act, Allahabad Law Agency, Haryana (14th edn.- 2009) p. 82.

[17] The SRB, 2020 prescribes a 36 month insurance cover.

[18] L. Ahlsarmadi, The Rights and Obligations of parties to a Surrogacy Contract, 4 Interdisciplinary Journal of Contemporary Research In Business 164, 170 (2012), available at https://ift.tt/2R1F9gH, last seen on 06/08/2020.

[19] Ibid at 172.

[20] D. Munjal-Shankar, COMMERCIAL SURROGACY IN INDIA: VULNERABILITY CONTEXTUALISED, Volume no. 58 Journal of the Indian Law Institute 350, 356 (2016).

[21] B.K. Parthasarathi vs Government Of A.P. And Others, 2000 (1) ALD 199, 1999 (5) ALT 715.

[22] Cabinet approves the Assisted Reproductive Technology Regulation Bill 2020, PM INDIA, available at https://ift.tt/2ZcLCtR., last seen on 09/08/2020.

[23] B.K. Parthasarathi vs Government Of A.P. And Others, 2000 (1) ALD 199, 1999 (5) ALT 715.

[24] S. Kumar, India’s Proposed Commercial Surrogacy Ban Is an Assault on Women’s Rights, The Wire (09/11/2019), available at https://ift.tt/2ZacMkU, last seen on 11/08/2020.

Author:

Aditya Shete is a 2nd year student of BALLB at ILS Law College Pune.

His areas of academic interest include- Bio-ethics, International Law, IPR, Constitution and Criminal law. Aditya aspires to pursue a career in litigation.

The post Analysis: Surrogacy Procedures in India and the Laws appeared first on Legal Desire.

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[cnrgcommons]

Manager of clinical Quality Improvement

Planned Parenthood Columbia Willamette (PPCW) is committed to providing, promoting, and protecting access to sexual and reproductive health care in Oregon and Southwest Washington. Since 1963, PPCW has provided a broad range of sexual and reproductive health care, including family planning, preventative care, and other medical services; trained and educated community members on issues of sexuality; and advocated for the protection of reproductive rights and freedom in Oregon and Southwest Washington. Each year, more than 58,000 women, men and teens visit a PPCW health center, located in NE and SE Portland, Milwaukie, Beaverton, Salem, and Bend, Oregon; and Vancouver, Washington.

We believe that we are leading a movement for reproductive health care and education, and we are looking for people who want to help us transform the world. As our Manager of Clinical Quality Improvement, we can offer you:

-          A supportive atmosphere and collaborative environment

-          A focus on education and prevention

-          Organizational emphasis on high-quality practices

-          The unique chance to combine mission with medical practice

-          A gratifying personal experience

Position Details: This is a non-represented, exempt position.

Schedule: Full-time (37.5 hours/week).

Benefits: 4.2 weeks Paid Time Off (starting rate for first 2 years), excellent employer-paid Medical, Dental, and Vision Insurance, FSA, Short and Long Term Disability, Life AD&D Insurance, 403b Retirement Fund, and employee assistance program.

Compensation: $73,500 + DOE.

Minimum Qualifications:

• Licensure as a registered nurse and BSN degree required.  • Five (5) years progressive clinical and/or administrative experience, quality focus desired. • Prior supervisory or management experience in a related health care field. • Must have a current CPR certification. • Knowledge and experience in OSHA, CLIA, privacy laws, access, and release of information, quality and risk management and related guidelines and requirements. • Experience in Women’s Health preferred. • Professional, positive attitude with proven ability to contribute effectively to highly functioning work teams.

Application Process: This position will be open until filled; however, interviewing will likely begin no sooner than early May. Please refrain from inquiring about your application status until mid-May. Applications must be submitted online through our website - click "Apply Now" at the bottom of the listing. Applications submitted without a cover letter will NOT be reviewed. Please upload your resume and cover letter as one PDF in the submitted/additional documents section. Applicants who do not meet the above stated minimum requirements will not be considered.

Position Summary:

Under the supervision of the Director of Clinical Services, the Manager of Clinical Quality Improvement (CQI) is responsible for administering the affiliate’s clinical quality improvement program in accordance with customer and agency requirements.  This position monitors and ensures affiliate compliance with standards of quality patient care, PPFA accreditation standards, applicable state licensing requirements, and other applicable federal/state regulations.  The Manager of Clinical Quality Improvement monitors and analyzes the trends in documentation, treatment protocol and service delivery, and serves as the agency’s HIPAA Privacy Officer. This position oversees the department functions of all quality management and improvement services in PPCW health centers, including the following:

Clinical risk management

Incident reporting

Quality Improvement

Patient safety

Laboratory Services, CLIA

HIPAA

The Manager of CQI is responsible for objectively and systematically monitoring and evaluating the quality and appropriateness of patient care.  They pursue opportunities to improve patient care and satisfaction and assist in the resolution of problems that are identified.  Provides clinical support and training to the Case Management team, which includes both licensed and non-licensed staff.

Essential Functions:

Coordinate all quality management activities, relating directly to health center activities, including medical, EHR and clinical audits. Monitor and maintain audits on care and services; compile data and assist centers in developing corrective action plans.  This includes, but is not limited to, follow-up referrals, HIPAA, contraceptive management, special services, surgical procedures and consumer feedback.

Serve as agency HIPAA Privacy Officer.

Compile statistical data and write narrative reports summarizing quality assurance findings, for internal quality improvement purposes, and as required by PPFA,Title X, NAF, VFC, etc.

Document, evaluate and follow-up on any medical occurrences.  Oversee the Incident Reporting system per current ARMS guidelines. Prepare quarterly summary report for Medical Management Team and annual report for PPCW Board of Directors

Maintain legal hold system and coordinates release of information from medical records.

Provide ongoing training and develop training tools for all health center staff on Quality Management as it relates to clinical practice.

Conduct clinical safety meetings with the safety clinic assistants every other month.

Receive and relay all legal correspondence for review by Chief Operating Officer, Corporate Compliance Manager, ARMS and agency counsel as appropriate.

Manage laboratory services in conjunction with the Director of Laboratory Services ensuring quality and cost-effective lab services, including proficiency testing and applications, licensure applications, CLIA laboratory quality assurance assays, and associated report preparation and submission.

Ensure compliance with Vaccine for Children (VFC) program and other vaccine administration.

In collaboration with the Medical Management Team, PS Administation and the Chief Operating Officer, update appropriate departmental policies and procedures.

Assume responsibility for special projects or other duties as assigned.

Coordinate the Employee Exposure/Blood Borne Pathogen program in collaboration with Human Resources.

Additional reasonable tasks and responsibilities as assigned by supervisor.

Required Skills:

Leadership – Outstanding leadership with demonstrated excellent internal and external customer service skills and a commitment to providing the highest level of customer satisfaction

Strategic Thinking – Able to develop strategies in support of the organization and establish plans to execute

Business Knowledge – Thorough knowledge of agency standards, guidelines, policies, procedures. Understands products and services; knowledgeable of operations and fiscal responsibilities

Management – Plans resources, organizes and adjusts to achieve goals through collective efforts

Organization – Strong organizational skills. Able to manage multiple issues and projects as well as responding to unplanned issues.

Team player – Demonstrates behavior that brings people together to solve problems and achieve results Proven ability to contribute effectively to highly functioning work teams

Confidential – Able to manage information in a way that honors all parties; acts with integrity and professionalism

Communication Skills – Excellent verbal and written communication skills; articulate, professional, and able to communicate effectively with patients, all PPCW staff (administrative, clinical and non-clinical) and members of the community

Problem Solving/Objectivity – Must be analytical and a creative problem solver

Technology/Tools – Proficiency in NextGen, Microsoft Word, Excel and Power Point and Outlook.  Willingness and ability to adapt to change, including advances in technology

Travel – Required to travel to all health centers. Must have reliable transportation and a valid driver’s license

Employee Agreements:

Accountability – Takes personal responsibility for the quality and timeliness of work.  Accepts responsibility for mistakes and identify ways to improve.  Communicate expectations of others clearly and directly.  Complies with established policies, rules, and workplace expectations. 

Equity – Creates an inclusive and welcoming work environment by practicing equity, learning to appreciate difference, challenging inequity, and striving for justice.

Integrity – Performs and communicates in a truthful and ethical manner. Fosters a work environment that values and demonstrates trust and honesty.  Respects and maintains confidentiality.

Mission-Oriented – Work activities and priorities support the mission, strategic direction, and financial sustainability of the organization. 

Relationship Building – Builds positive working relationships characterized by a high level of acceptance, cooperation, and mutual respect.  Promote collaboration and commitment within teams to achieve goals and deliverables.

  Planned Parenthood Columbia Willamette is an equal employment opportunity employer and is committed to maintaining a non-discriminatory work environment.  We do not discriminate against any employee or applicant for employment on the basis of race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, national origin, marital status, age, mental or physical disability, genetic information, application for workers’ compensation benefits, use of statutory protected leave, veteran or military status, pregnancy, union activity, or any other characteristic or status protected by applicable federal, state or local laws.  Planned Parenthood is committed to creating a dynamic work environment that values diversity and inclusion, respect and integrity, customer focus, and innovation